Mika Kortesniemi (HYKS) Säteilyturvallisuustutkimus Suomessa -seminaarissa 5.11.2014

1. Dosimetrinen tutkimus
diagnostiikassa ja hoidoissa
Helsingin yliopistossa ja Helsingin
yliopistollisessa sairaalassa
HELSINKI UNIVERSITY
DEPARTMENT OF PHYSICS
Mika Kortesniemi
Adjunct Professor, Chief Physicist, PhD
HUS Medical Imaging Center
University of Helsinki
Meilahti Hospital, Dept. of Radiology
(HYKS)
Helsinki 2014
neutronisäteilytykseen ja boori-neutronikaappausreaktioon
Potilas saa
BPA-F
kantaja-aineen
infuusion
BNCT – kantaja-aineen infuusiosta
Boorin optimaalinen
kerääntyminen
hoidettavaan
kasvaimeen
BPA-F leviää
verenkiertoon
ja kudoksiin
Oikein kohdistettu ja
ajoitettu neutronisäteilytys
Mikrotaso
10B[n,a]7Li
reaktio
neutroni
alfa-hiukkanen
7Li -
rekyyliydin
10B -ydin
Solun sisällä tapahtuvassa boori-neutronikaappaus-reaktiossa
syntyvät alfahiukkanen ja litiumrekyyli rikkovat
solurakenteita muutaman mikrometrin matkalla ja näin
tuhoavat kasvainsolun.
~2h
mika.kortesniemi@hus.fi
Data flow during the BNCT treatment
Prescribed
normal tissue
dose limit, DLNT
Gy(W)
Beam data
Treatment planning data
Normal tissue
dose rate, dDNT/dt
Gy(W)/h
Ref. beam
monitor (N1)
count rate
dNBM, ref/dt
Ref. boron dose
rate, dWBDB/dt
Gy(W)/h
Ref. total
dose rate, dDW/dt
Gy(W)/h
Simulated blood
boron level, CS
mg/kg
Irradiation field
weights, WF(i),
and aperture
sizes
Boron data
Experimental
blood boron data
ICP-AES
mg/kg
Estimated blood
boron level, CB
mg/kg
Irradiation time, IT
min
Beam monitor
(N1) counts, NBM
mika.kortesniemi@hus.fi
List of contributors
This report has been compiled by
Hannu Järvinen, STUK, Finland and
Willem P. Voorbraak, NRG, The Netherlands
from 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 partners
This 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 and
was sponsored by the European Commission under contract numbers SMT4-CT98-2145 and IC20-CT98-
0013.
Recommendations for the
Dosimetry of Boron Neutron
Capture Therapy (BNCT)
mika.kortesniemi@hus.fi
Simulations in radiation dosimetry
Photon beam to Pb-target
(photons and secondary particles)
Eero Hippeläinen
Two point sources in water cylinder
(activity from gamma image, attenuation
values from CT image)
Radiation therapy
Collaboration (HYKS-TAYS-STUK) within European Metrology project concerning
dosimetry 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 measurement
program of external photon radiotherapy beams? Phys Med Biol. 2011 Apr 7;56(7):2119-30.
2. Keyriläinen J, FernándezM, Bravin A, Karjalainen-LindsbergML, LeideniusM, von Smitten K, Tenhunen M, Kangasmäki A, Sipilä
P, Nemoz C, Virkkunen P, Suortti P. Comparison of in vitro breast cancer visibility in analyser-based computed tomography
with histopathology, mammography, computed tomography and magnetic resonance imaging. J Synchrotron Radiat. 2011
Sep;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 radiotherapy
beams in Finland: the quality of local beamdata and the use of averaged data. Radiother Oncol. 2008 Feb;86(2):264-71.
4. Bravin A, Keyriläinen J, FernándezM, Fiedler S, Nemoz C, Karjalainen-LindsbergML, Tenhunen M, Virkkunen P, LeideniusM,
von Smitten K, Sipilä P, Suortti P. High-resolution CT by diffraction-enhanced x-ray imaging: mapping of breast tissue samples
and 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 tolerance
on treatment dose deviation in photon external beamradiotherapy. 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 eightmodern
radiotherapy linear accelerators: the short- and long-term behaviours of the outputs and the reproducibility of quality control
measurements. Phys Med Biol. 2006 Jul 21;51(14):3581-92.
Mika Kortesniemi, Finland 1

2. Optimisation research in digital radiology
Part of MATRENA, University of Helsinki
Doctoral Programme in Materials Research
and Nanosciences
mika.kortesniemi@hus.fi 8
Example : CT dose simulation for 3D organ dosimetry
Organ dose
volume histograms
Dose
Mean organ doses (mGy)
Thyroid 0.4
Breasts 15.8
Lungs 12.4
Heart 12.5
Liver 14.7
Kidneys 14.7
Skin 6.6
Uterus 11.9
absorbed
dose
distribution
Volume
Segmented Effective dose11.4 mSv
human model
3D
CT scan
with tube
current
modulation
Example: experimental CT dosimetry
in anthropomorphic pediatric model
Pediatric 5y antropomorphic phantom with inserted MOSFET dosimeters.
Ref.dose
determination
Dosemeter
calibration
Point organ doses (mGy)
Thyroid 0.3
Breasts 6.5
Lungs 6.2
Heart 6.5
Liver 7.9
Kidneys 7.2
Effective dose3.4 mSv
Example: simulated CT image quality and resolution metrics
10 mAs 800 mAs
DOSE
LEVEL
Reference image
140 kV
SPECTRUM
2D NPS
distribution
RESOLUTION
METRICS
80 kV
Iterative
method
FBP Bone
kernel
3D-MTF
contour
IMAGE
RECON-STRUCTION
10 Recent publications – optimisation in radiology
1. Koivisto J, Wolff J, Järnstedt J, Dastidar P, Kortesniemi M. Assessment of the effective dose in supine, prone, and oblique
positions in themaxillofacial region using a novel combined extremity and maxillofacial cone beamcomputed tomography
scanner. 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 phantomand patient
data 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. AJR
Am 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 and
conventional X ray for knee areausing 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 rotational
axes 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 in
pediatric chest CT-phantomstudy. 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 thewrist using a
novel, 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 J
Roentgenol. 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 dosimetry
of 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 acceptance
and 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.
Mika Kortesniemi, Finland 2