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  • 1.
    Asklund, Thomas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Hauksson, Jon
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Brynolfsson, Patrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Evaluation of advanced MR techniques for development of early biomarkers for treatment efficacy in malignant brain tumors2010Conference paper (Refereed)
  • 2. Björeland, Anders
    et al.
    Blomquist, Michael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Sätherberg, Anders
    Bergström, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Franzén, Lars
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Joint Center - samarbetsprojekt för optimal strålbehandling i närmiljö2004In: Läkartidningen, ISSN 0023-7205, Vol. 101, no 6, p. 472-475Article in journal (Refereed)
  • 3. Björeland, Anders
    et al.
    Lindvall, Peter
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Karlsson, Anna
    Gustavsson, Helen
    Bäck, Sven A J
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bergenheim, Tommy A
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Liquid ionization chamber calibrated gel dosimetry in conformal stereotactic radiotherapy of brain lesions2008In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 47, no 6, p. 1099-1109Article in journal (Refereed)
    Abstract [en]

    Hypofractionated conformal stereotactic radiotherapy (HCSRT) is an established method of treating brain lesions such as arteriovenous malformations (AVMs) and brain metastases. The aim of this study was to investigate the reliability of treatment plans in the terms of dose distribution and absorbed dose for HCSRT.

    Methods and materials. Treatment plans for three different clinical intracerebral targets, AVMs, were transferred to a CT study of a spherical water filled phantom simulating the human head and recalculated for the phantom geometry using a standard treatment planning system utilizing a pencil beam algorithm for dose calculation. The calculated absorbed dose, relative three dimensional (3D) dose distribution and dose conformity were investigated using gel dosimetry normalized to liquid ionization chamber (LIC) measurements.

    Results. The measured absorbed dose to the dose reference point was found to be within 2% of the calculated dose for all three targets. The measured dose distribution was found to be within 3% and 2 mm of the calculated dose for more than 93% of all points in the target volume for all three targets.

    Conclusions. The results show that the investigated standard treatment planning system can correctly predict the absorbed dose and dose distribution in different types of intracerebral targets and that the treatment can be delivered according to the plan.

  • 4.
    Blomquist, M
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, M G
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Zackrisson, B
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Multileaf collimation of electrons-clinical effects on electron energy modulation and mixed beam therapy depending on treatment head design2002In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 47, no 7, p. 1013-1024Article in journal (Refereed)
    Abstract [en]

    The aim Of this Study was to explore the possibilities of using multileaf-collimated electron beams for advanced radiation therapy with conventional scattering foil flattened beams. Monte Carlo simulations were performed with the aim to improve electron beam characteristics and enable isocentric multileaf collimation. The scattering foil positions, monitor chamber thickness, the MLC location and the amount of He in the treatment head were optimized for three common commercial accelerators. The performance of the three optimized treatment head designs was compared for different SSDs in air. at treatment depth in water and for some clinical cases. The effects of electron/photon beam matching including generalized random and static errors using Gaussian one-dimensional (1D) error distributions, and also electron energy modulation, were studied at treatment depth in beater, The modification of the treatment heads improved the electron beam characteristics and enabled the use of multileaf collimation in isocentric delivery of both electron and photon beams in a mixed beam IMRT procedure.

  • 5.
    Blomquist, M
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Measured lung dose correction factors for 50 MV photons1998In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 43, no 11, p. 3225-3234Article in journal (Refereed)
    Abstract [en]

    Some clinically relevant measurements of lung tissue/water equivalent interfaces have been performed for a 50 MV therapeutic x-ray beam. The purpose was to investigate the severity of dose perturbation effects in lung tissue and adjacent tissues using an energy well above the common clinical practice in thoracic irradiations. The phantoms were constructed of solid water, PMMA and white polystyrene as soft tissue (water) equivalents, and cork was used as the lung tissue equivalent. Measurements were performed using radiographic film and a cylindrical ionization chamber. The results show that the degradation of the 20/80% beam penumbra in the lung region is severe, up to 2.5 times the penumbra in water for a 10 cm thick lung with a density of 0.30 x 10(3) kg m(-3). The lack of electronic equilibrium in the low-density region can cause underdosage at the lung/tumour interface of up to 30% of maximum target dose, and the build-up depth to 95% of target dose in unit density tissue behind the lung may be as large as 22 mm. It is also shown that these figures strongly depend on patient anatomy and beam size and why a careful calculation of the individual dose distribution is needed for optimal choice of photon beam energy in thoracic treatments.

  • 6.
    Blomquist, M
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Test procedures for verification of an electron pencil beam algorithm implemented for treatment planning1996In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 39, no 3, p. 271-286Article in journal (Refereed)
    Abstract [en]

    The calculation of an electron dose distribution in a patient is a difficult problem because of the presence of tissue and surface inhomogeneities. Verification of the dose planning system is therefore essential. In this investigation, a novel method is used to evaluate a commercially available system (Helax-TMS), at electron energies between 10 and 50 MeV, both for a conventional treatment unit and an MLC-collimated scanned beam unit with a helium-filled treatment head. First, the experiments were designed to verify the local beam database and some fundamental characteristics of the electron beam calculations. Secondly, a number of generalised situations that would be encountered in the clinical treatment planning were evaluated: oblique incidence, field shaping with multi-leaf collimator, bolus edges, and air cavities. Dose distributions in two generalised anatomical phantoms simulating a neck and a nose were also analysed. The results have, when so possible, been presented as the dose ratio within the 'flattened area' for dose profiles and down to the 'treatment depth' (80% dose level) for depth doses. In the penumbra region and in the dose fall-off region, the comparison has been represented by the distance deviation between calculated and measured dose profiles or depth doses. A new tool, 'volume integration', was used to evaluate the deviations from a more clinical point of view. Most results were within +/-2% in dose for volumes larger than a sphere with a diameter of 15 mm, or +/-2 mm in position. Dose deviations were generally found for oblique incidences and below heterogeneities such as small air cavities and bolus edges in limited volumes.

  • 7.
    Blomquist, M
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ma, C M
    Zackrisson, B
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Comments on 'X-ray energy choice for lung tumour irradiation depends on the density distribution of clonogenic cells'2003In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 48, no 8, p. L29-L30Article in journal (Refereed)
  • 8.
    Blomquist, M
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Li, J S
    Ma, C M
    Zackrisson, B
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Comparison between a conventional treatment energy and 50 MV photons for the treatment of lung tumours2002In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 47, no 6, p. 889-897Article in journal (Refereed)
    Abstract [en]

    Radiation therapy in the thoracic region is difficult due to the presence of many dose-limiting structures and the large density differences that affect the dose distribution. Conventional irradiation techniques use low-energy photon beams to avoid build-up effects superficially in the tumour and increased lateral scattering of the beams. For deep-seated tumours higher beam energies could have lung-sparing properties that would enable dose escalation. A comparison was made for a conventional low photon energy (6 MV) and 50 MV photons for the treatment of a lung tumour. A representative patient geometry was selected, consisting of a small tumour semi-enclosed in lung tissue. Treatment plans were designed using a commercial 3D-pencil beam treatment planning system. The treatment beams designed in the TPS were simulated with the Monte Carlo code EGS4/BEAM and the dose distribution in the phantom created from the patients CT-data was calculated using MCDOSE with identical beam geometry for both energies. The intrinsic difference between the two photon energies implies a sparing effect of lung that can be utilized for dose escalation. For a treatment with two beams the mean total dose to the tumour could be increased by 5.3% for 50 MV, corresponding to 3.2 Gy for a prescription dose of 60 Gy, with the same complication probability for the treated lung as for 6 MV. In conclusion, high-energy beams have qualities that can be taken advantage of for irradiation of lung tumours. Optimum solutions would probably require the use of both high- and low-energy beams.

  • 9.
    Blomquist, M
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Satherberg, A
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Zackrisson, B
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Scanned intensity modulations for 50 MV photons1998In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 43, no 5, p. 1185-1197Article in journal (Refereed)
    Abstract [en]

    Optimization of the dose distributions by individual beam compensation is a useful tool in conformal radiation therapy. Intensity modulation by electromagnetic scanning of a narrow elementary beam allows fast dose delivery and causes little change in beam quality compared with other methods, especially for high energies such as 50 MV. Intensity modulated beams from the MM50 accelerator were measured and compared with calculations based on Monte Carlo simulations. Good agreement between measurements and calculations were found, typically within 1% for central dose profiles. The steepest wedge angle that was produced with the scanning beam technique was of 45 degrees or 3.5% cm(-1) for a 20 cm x 20 cm field, slightly varying with depth. The elementary 50 MV photon 'pencil beam' for a full range, high-z bremsstrahlung target, is a wide dose distribution at 10 cm depth in water which limits the modulation gradient and hence the complexity of the modulation by the scanning of a photon pencil beam only. Scanned wedge beam distributions were modelled in the treatment planning system and a pelvic treatment with three fields was used to illustrate a clinical application. The resulting dose volume data were compared for different radiation qualities but with similar beam portals. 'Energy modulation' by field matching with lower photon energies was performed to sharpen the penumbra towards organs at risk.

  • 10.
    Brynolfsson, Patrik
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nilsson, David
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Hauksson, Jon
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Birgander, Richard
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Trygg, Johan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    ADC texture-An imaging biomarker for high-grade glioma?2014In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 41, no 10, p. 101903-Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Survival for high-grade gliomas is poor, at least partly explained by intratumoral heterogeneity contributing to treatment resistance. Radiological evaluation of treatment response is in most cases limited to assessment of tumor size months after the initiation of therapy. Diffusion-weighted magnetic resonance imaging (MRI) and its estimate of the apparent diffusion coefficient (ADC) has been widely investigated, as it reflects tumor cellularity and proliferation. The aim of this study was to investigate texture analysis of ADC images in conjunction with multivariate image analysis as a means for identification of pretreatment imaging biomarkers.

    Methods:

    Twenty-three consecutive high-grade glioma patients were treated with radiotherapy (2 Gy/60 Gy) with concomitant and adjuvant temozolomide. ADC maps and T1-weighted anatomical images with and without contrast enhancement were collected prior to treatment, and (residual) tumor contrast enhancement was delineated. A gray-level co-occurrence matrix analysis was performed on the ADC maps in a cuboid encapsulating the tumor in coronal, sagittal, and transversal planes, giving a total of 60 textural descriptors for each tumor. In addition, similar examinations and analyses were performed at day 1, week 2, and week 6 into treatment. Principal component analysis (PCA) was applied to reduce dimensionality of the data, and the five largest components (scores) were used in subsequent analyses. MRI assessment three months after completion of radiochemotherapy was used for classifying tumor progression or regression.

    Results:

    The score scatter plots revealed that the first, third, and fifth components of the pretreatment examinations exhibited a pattern that strongly correlated to survival. Two groups could be identified: one with a median survival after diagnosis of 1099 days and one with 345 days, p = 0.0001.

    Conclusions:

    By combining PCA and texture analysis, ADC texture characteristics were identified, which seems to hold pretreatment prognostic information, independent of known prognostic factors such as age, stage, and surgical procedure. These findings encourage further studies with a larger patient cohort. (C) 2014 Author(s).

  • 11.
    Dasu, A
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Toma-Dasu, I
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    The issue of dose modifying factors for risk estimations for protons2005Conference paper (Refereed)
  • 12.
    Dasu, Alexandru
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Toma-Dasu, Iuliana
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    The effects of hypoxia on the theoretical modelling of tumour control probability2005In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 44, no 6, p. 563-571Article in journal (Refereed)
    Abstract [en]

    Theoretical modelling of tumour response is increasingly used for the prediction of treatment result and has even been proposed as ranking criteria in some algorithms for treatment planning. Tumour response to radiation is greatly influenced by the details of tumour microenvironment, especially hypoxia, that unfortunately are not always taken into consideration for these simulations. This paper intends to investigate the effects of various assumptions regarding hypoxia distribution in tumours on the predictions of treatment outcome. A previously developed model for simulating theoretically the oxygenation in biologically relevant tissues, including results from oxygen diffusion, consumption and perfusion limitations in tumours, was used to investigate the effects of the different aspects of hypoxia on the predictions of treatment outcome. Thus, both the continuous distribution of values and the temporal variation of hypoxia patterns were taken into consideration and were compared with a `black-and-white' simplification with a fully hypoxic compartment and a fully oxic one. It was found that the full distribution of oxygenation in the tissue is needed for accurate results. The `black-and-white' simplification, while showing the same general trends for the predictions of radiation response, could lead to serious overestimations of the tumour control probability. It was also found that the presence of some hypoxia for every treatment fraction leads to a decrease in the predicted local control, regardless of the change of the hypoxic pattern throughout the duration of the whole treatment. The results thus suggest that the assumptions regarding tumour hypoxia influence very much the predictions of treatment outcome and therefore they have to be very carefully incorporated into the theoretical modelling.

  • 13.
    Dasu, Alexandru
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Toma-Dasu, Iuliana
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Theoretical simulation of tumour oxygenation and results from acute and chronic hypoxia2003In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 48, no 17, p. 2829-2842Article in journal (Refereed)
    Abstract [en]

    The tumour microenvironment is considered to be responsible for the outcome of cancer treatment and therefore it is extremely important to characterize and quantify it. Unfortunately, most of the experimental techniques available now are invasive and generally it is not known how this influences the results. Non-invasive methods on the other hand have a geometrical resolution that is not always suited for the modelling of the tumour response. Theoretical simulation of the microenvironment may be an alternative method that can provide quantitative data for accurately describing tumour tissues.

    This paper presents a computerized model that allows the simulation of the tumour oxygenation. The model simulates numerically the fundamental physical processes of oxygen diffusion and consumption in a two-dimensional geometry in order to study the influence of the different parameters describing the tissue geometry. The paper also presents a novel method to simulate the effects of diffusion-limited (chronic) hypoxia and perfusion-limited (acute) hypoxia.

    The results show that all the parameters describing tissue vasculature are important for describing tissue oxygenation. Assuming that vascular structure is described by a distribution of inter-vessel distances, both the average and the width of the distribution are needed in order to fully characterize the tissue oxygenation. Incomplete data, such as distributions measured in a non-representative region of the tissue, may not give relevant tissue oxygenation.

    Theoretical modelling of tumour oxygenation also allows the separation between acutely and chronically hypoxic cells, a distinction that cannot always be seen with other methods. It was observed that the fraction of acutely hypoxic cells depends not only on the fraction of collapsed blood vessels at any particular moment, but also on the distribution of vessels in space as well.

    All these suggest that theoretical modelling of tissue oxygenation starting from the basic principles is a robust method that can be used to quantify the tissue oxygenation and to provide input parameters for other simulations.

  • 14.
    Dasu, Alexandru
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Toma-Dasu, Iuliana
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    The use of risk estimation models for the induction of secondary cancers following radiotherapy2005In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 44, no 4, p. 339-347Article in journal (Refereed)
    Abstract [en]

    Theoretical predictions of cancer risk from radiotherapy may be used as a complementary criterion for the selection of successful treatment plans together with the classical approach of estimating the possible deterministic effects. However, any such attempts must take into consideration the specific features of radiation treatment. This paper explores several possible methods for estimating the risk of cancer following radiotherapy in order to investigate the influences of the fractionation and the non-uniformity of the dose to the irradiated organ. The results indicate that dose inhomogeneity plays an important role in predicting the risk for secondary cancer and therefore for predictive purposes it must be taken into account through the use of the dose volume histograms. They also suggest that the competition between cell killing and the induction of carcinogenic mutations has to be taken into consideration for more realistic risk estimations. Furthermore, more realistic parameters could be obtained if this competition is also included in analyses of epidemiological data from radiotherapy applications.

  • 15. Faddegon, B A
    et al.
    Svatos, M
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, L
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Antolak, J A
    Treatment head design for mixed beam therapy2002Conference paper (Refereed)
  • 16.
    Franzén, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Gustafsson, H
    Sundström, S
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Littbrand, Bo
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Fractionated-irradiation and late changes in rat parotid-gland: effects on the number of acinar-cells, potassium efflux, and amylase secretion1993In: International Journal of Radiation Biology, ISSN 0955-3002, E-ISSN 1362-3095, Vol. 64, no 1, p. 93-101Article in journal (Refereed)
    Abstract [en]

    Irradiation of head- and neck cancer commonly results in oral dryness and discomfort for the patients due to salivary gland damage. The exact mechanisms behind the inherent radiosensitivity of salivary glands remain to be elucidated. In the present study, we used different in vitro secretory models and quantitative morphological characterization of rat parotid gland following fractionated unilateral irradiation to one gland on a 5-day fraction schedule (Monday-Friday) with 6 MV photons (total dose 30, 35, 40 and 45 Gy) or a two-fractions regimen in 5 days (Monday and Friday) with total dose of 24 and 32 Gy. The contralateral shielded gland served as control, and parallel analyses of irradiated and control glands were performed 180 days following the last irradiation treatment. The relative noradrenaline stimulated electrolyte secretion (rubidium-86 tracer for potassium) was decreased in the irradiated compared with control glands. The noradrenaline-stimulated exocytotic amylase release was not significantly affected by irradiation, but the gland content of amylase was decreased dose-dependently. The quantitative morphological analysis revealed a dose-dependent decline in the number of acinar cells, whereas the other parenchymal cells (intercalated, striated- and excretory duct cells) were un-, affected by the irradiation compared with control glands.

  • 17.
    Franzén, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Sundström, Staffan
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Histology and Cell Biology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Gustafsson, Hans
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Littbrand, Bo
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Fractionated irradiation and early changes in noradrenaline induced potassium efflux(86Rb+) in rat parotid gland1992In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 31, no 3, p. 359-364Article in journal (Refereed)
    Abstract [en]

    The effects of fractionated irradiation on the electrolyte fluid secretion from rat parotid gland were studied. Secretion was measured as noradrenaline stimulated potassium efflux in vitro with Rb-86+ as tracer for potassium. The irradiation was delivered either as a five-day schedule (total dose 20, 25, 30, 35, 40, 45 Gy) or a two-day schedule (total dose 24, 32 Gy). The noradrenaline stimulated efflux was decreased in comparison with contralateral controls 10 days after the last irradiation. The effect was dose-dependent. Based on the data available, alpha/beta ratio of the used system was calculated to about 20 Gy, which corresponds to other results regarding early radiation effects.

  • 18.
    Garpebring, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Brynolfsson, Patrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Yu, Jun
    Sveriges lantbruksuniversitet, Centre of Biostochastiscs.
    Wirestam, Ronnie
    Lunds universitet, Medicinsk strålningsfysik.
    Johansson, Adam
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Uncertainty estimation in dynamic contrast-enhanced MRI2013In: Magnetic Resonance in Medicine, ISSN 0740-3194, E-ISSN 1522-2594, Vol. 69, no 4, p. 992-1002Article in journal (Refereed)
    Abstract [en]

    Using dynamic contrast-enhanced MRI (DCE-MRI), it is possible to estimate pharmacokinetic (PK) parameters that convey information about physiological properties, e.g., in tumors. In DCE-MRI, errors propagate in a nontrivial way to the PK parameters. We propose a method based on multivariate linear error propagation to calculate uncertainty maps for the PK parameters. Uncertainties in the PK parameters were investigated for the modified Kety model. The method was evaluated with Monte Carlo simulations and exemplified with in vivo brain tumor data. PK parameter uncertainties due to noise in dynamic data were accurately estimated. Noise with standard deviation up to 15% in the baseline signal and the baseline T1 map gave estimated uncertainties in good agreement with the Monte Carlo simulations. Good agreement was also found for up to 15% errors in the arterial input function amplitude. The method was less accurate for errors in the bolus arrival time with disagreements of 23%, 32%, and 29% for Ktrans, ve, and vp, respectively, when the standard deviation of the bolus arrival time error was 5.3 s. In conclusion, the proposed method provides efficient means for calculation of uncertainty maps, and it was applicable to a wide range of sources of uncertainty.

  • 19.
    Garpebring, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Brynolfsson, Patrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Yu, Jun
    Wirestam, Ronnie
    Radiofysik, Lunds Universitet.
    Johansson, Adam
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Thomas, Asklund
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Uncertainty Maps in Dynamic Contrast-Enhanced MRI2012Conference paper (Refereed)
  • 20.
    Garpebring, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Brynolfsson, Patrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Yu, Jun
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Wirestam, Ronnie
    Radiofysik, Lunds Universitet.
    Johansson, Adam
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Thomas, Asklund
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Uncertainty Maps in Dynamic Contrast-Enhanced MRI2012Conference paper (Refereed)
  • 21.
    Garpebring, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Wirestam, Ronnie
    Yu, Jun
    SLU, Centre of Biostochastics.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Phase-based arterial input functions in humans applied to dynamic contrast-enhanced MRI: potential usefulness and limitations2011In: Magnetic Resonance Materials in Physics, Biology and Medicine, ISSN 0968-5243, E-ISSN 1352-8661, Vol. 24, no 4, p. 233-245Article in journal (Refereed)
    Abstract [en]

    Object: Phase-based arterial input functions (AIFs) provide a promising alternative to standard magnitude-based AIFs, for example, because inflow effects are avoided. The usefulness of phase-based AIFs in clinical dynamic contrast-enhanced MRI (DCE-MRI) was investigated, and relevant pitfalls and sources of uncertainty were identified.

    Materials and methods: AIFs were registered from eight human subjects on, in total, 21 occasions. AIF quality was evaluated by comparing AIFs from right and left internal carotid arteries and by assessing the reliability of blood plasma volume estimates.

    Results: Phase-based AIFs yielded an average bolus peak of 3.9 mM and a residual concentration of 0.37 mM after 3 min, (0.033 mmol/kg contrast agent injection). The average blood plasma volume was 2.7% when using the AIF peak in the estimation, but was significantly different (p < 0.0001) and less physiologically reasonable when based on the AIF tail concentration. Motion-induced phase shifts and accumulation of contrast agent in background tissue regions were identified as main sources of uncertainty.

    Conclusions: Phase-based AIFs are a feasible alternative to magnitude AIFs, but sources of errors exist, making quantification difficult, especially of the AIF tail. Improvement of the technique is feasible and also required for the phase-based AIF approach to reach its full potential.

  • 22.
    Garpebring, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Wirestam, Ronnie
    Östlund, Nils
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Effects of inflow and radiofrequency spoiling on the arterial input function in dynamic contrast-enhanced MRI: a combined phantom and simulation study2011In: Magnetic Resonance in Medicine, ISSN 0740-3194, E-ISSN 1522-2594, Vol. 65, no 6, p. 1670-1679Article in journal (Refereed)
    Abstract [en]

    The arterial input function is crucial in pharmacokinetic analysis of dynamic contrast-enhanced MRI data. Among other artifacts in arterial input function quantification, the blood inflow effect and nonideal radiofrequency spoiling can induce large measurement errors with subsequent reduction of accuracy in the pharmacokinetic parameters. These errors were investigated for a 3D spoiled gradient-echo sequence using a pulsatile flow phantom and a total of 144 typical imaging settings. In the presence of large inflow effects, results showed poor average accuracy and large spread between imaging settings, when the standard spoiled gradient-echo signal equation was used in the analysis. For example, one of the investigated inflow conditions resulted in a mean error of about 40% and a spread, given by the coefficient of variation, of 20% for K(trans) . Minimizing inflow effects by appropriate slice placement, combined with compensation for nonideal radiofrequency spoiling, significantly improved the results, but they remained poorer than without flow (e.g., 3-4 times larger coefficient of variation for K(trans) ). It was concluded that the 3D spoiled gradient-echo sequence is not optimal for accurate arterial input function quantification and that correction for nonideal radiofrequency spoiling in combination with inflow minimizing slice placement should be used to reduce the errors. Magn Reson Med, 2011. © 2011 Wiley-Liss, Inc.

  • 23.
    Garpebring, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Östlund, Nils
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    A novel estimation method for physiological parameters in dynamic contrast-enhanced MRI: application of a distributed parameter model using Fourier-domain calculations2009In: IEEE Transactions on Medical Imaging, ISSN 0278-0062, E-ISSN 1558-254X, Vol. 28, no 9, p. 1375-1383Article in journal (Refereed)
    Abstract [en]

    Dynamic contrast-enhanced magnetic resonance imaging (MRI) is a promising tool in the evaluation of tumor physiology. From rapidly acquired images and a model for contrast agent pharmacokinetics, physiological parameters are derived. One pharmacokinetic model, the tissue homogeneity model, enables estimation of both blood flow and vessel permeability together with parameters that describe blood volume and extracellular extravascular volume fraction. However, studies have shown that parameter estimation with this model is unstable. Therefore, several initial guesses are needed for accurate estimates, which makes the estimation slow. In this study a new estimation algorithm for the tissue homogeneity model, based on Fourier domain calculations, was derived and implemented as a Matlab program. The algorithm was tested with Monte-Carlo simulations and the results were compared to an existing method that uses the adiabatic approximation. The algorithm was also tested on data from a metastasis in the brain. The comparison showed that the new algorithm gave more accurate results on the 2.5th and 97.5th percentile levels, for instance the error in blood volume was reduced by 21%. In addition, the time needed for the computations was reduced with a factor 25. It was concluded that the new algorithm can be used to speed up parameter estimation while accuracy can be gained at the same time.

  • 24. Georg, Dietmar
    et al.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Kjaer-Kristoffersen, Flemming
    Schnekenburger, Bruno
    Winkler, Peter
    Nyström, Hakan
    Ahnesjo, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Clinical evaluation of monitor unit software and the application of action levels2007In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 85, no 2, p. 306-315Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was the clinical evaluation of an independent dose and monitor unit verification (MUV) software which is based on sophisticated semi-analytical modelling. The software was developed within the framework of an ESTRO project. Finally, consistent handling of dose calculation deviations applying individual action levels is discussed.

    Materials and methods: A Matlab-based software ("MUV") was distributed to five well-established treatment centres in Europe (Vienna, Graz, Basel, Copenhagen, and Umea) and evaluated as a quality assurance (QA) tool. in clinical routine. Results were acquired for 226 individual treatment plans including a total of 815 radiation fields. About 150 beam verification measurements were performed for a portion of the individual treatment plans, mainly with time variable fluence patterns. The deviations between dose calculations performed with a treatment planning system (TPS) and the MUV software were scored with respect to treatment area, treatment technique, geometrical depth, radiological depth, etc.

    Results: In general good agreement was found between calculations performed with the different TPSs and MUV, with a mean deviation per field of 0.2 +/- 3.5% (1 SD) and mean deviations of 0.2 +/- 2.2% for composite treatment plans. For pelvic treatments less than 10% of all fields showed deviations larger than 3%. In general, when using the radiological depth for verification calculations the results and the spread in the results improved significantly, especially for head-and-neck and for thorax treatments. For IMRT head-and-neck beams, mean deviations between MUV and the local TPS were -1.0 +/- 7.3% for dynamic, and -1.3 +/- 3.2% for step-and-shoot IMRT delivery. For dynamic IMRT beams in the pelvis good agreement was obtained between MUV and the local TIPS (mean: -1.6 +/- 1.5%). Treatment site and treatment technique dependent action levels between 3% and 5% seem to be clinically realistic if a radiological depth correction is performed, even for dynamic wedges and IMRT.

    Conclusion: The software MUV is well suited for patient specific treatment plan QA applications and can handle all currently available treatment techniques that can be applied with standard linear accelerators. The highly sophisticated dose calculation model implemented in MUV allows investigation of systematic TIPS deviations by performing calculations in homogeneous conditions. (c) 2007 Elsevier Ireland Ltd. All rights reserved.

  • 25. Georg, Dietmar
    et al.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Künzler, Thomas
    Aiginger, Hannes
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    A practical method to calculate head scatter factors in wedged rectangular and irregular MLC shaped beams for external and internal wedges2004In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 49, no 20, p. 4689-4700Article in journal (Refereed)
    Abstract [en]

    Factor based methods for absorbed dose or monitor unit calculations are often based on separate data sets for open and wedged beams. The determination of basic beam parameters can be rather time consuming, unless equivalent square methods are applied. When considering irregular wedged beams shaped with a multileaf collimator, parametrization methods for dosimetric quantities, e.g. output ratios or wedge factors as a function of field size and shape, become even more important. A practical method is presented to derive wedged output ratios in air (S-c,S-w) for any rectangular field and for any irregular MLC shaped beam. This method was based on open field output ratios in air (Sc) for a field with the same collimator setting, and a relation f(w) between S-c,S-w and S-c. The relation f(w) can be determined from measured output ratios in air for a few open and wedged fields including the maximum wedged field size. The function fw and its parametrization were dependent on wedge angle and treatment head design, i.e. they were different for internal and external wedges. The proposed method was tested for rectangular wedged fields on three accelerators with internal wedges (GE, Elekta, BBC) and two accelerators with external wedges (Varian). For symmetric regular beams the average deviation between calculated and measured S-c,S-w/S-c ratios was 0.3% for external wedges and about 0.6% for internal wedges. Maximum deviations of 1.8% were obtained for elongated rectangular fields on the GE and ELEKTA linacs with an internal wedge. The same accuracy was achieved for irregular MLC shaped wedged beams on the accelerators with MLC and internal wedges (GE and Elekta), with an average deviation < 1 % for the fields tested. The proposed method to determine output ratios in air for wedged beams from output ratios of open beams, combined with equivalent square approaches, can be easily integrated in empirical or semi-empirical methods for monitor unit calculations. 

  • 26. Georg, Dietmar
    et al.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Künzler, Thomas
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    On empirical methods to determine scatter factors for irregular MLC shaped beams2004In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 31, no 8, p. 2222-2229Article in journal (Refereed)
    Abstract [en]

    Multileaf collimators (MLCs) are in clinical use for more than a decade and are a well accepted tool in radiotherapy. For almost each MLC design different empirical or semianalytical methods have been presented for calculating output ratios in air for irregularly shaped beams. However, until now no clear recommendations have been given on how to handle irregular fields shaped by multileaf collimators for independent monitor unit (MU) verification. The present article compares different empirical methods, which have been proposed for independent MU verification, to determine (1) output ratios in air (S-P) and (2) phantom scatter factors (Sp) for irregular MLC shaped fields. Ten dedicated field shapes were applied to five different types of MLCs (Elekta, Siemens, Varian, Scanditronix, General Electric). All calculations based on empirical relations were compared with measurements and with calculations performed by a treatment planning system with a fluence based algorithm. For most irregular MLC shaped beams output ratios in air could be adequately modeled with an accuracy of about 1%-1.5% applying a method based on the open field aperture defined by the leaf and jaw setting combined with the equivalent square formula suggested by Vadash and Bjarngard [P. Vadash and B. E. Bjarngard, Med. Phys. 20, 733-734 (1993)]. The accuracy of this approach strongly depends on the inherent head scatter characteristics of the accelerator in use and on the irregular field under consideration. Deviations of up to 3% were obtained for fields where leaves obscure central parts of the flattening filter. Simple equivalent square methods for S-P calculations in irregular fields did not provide acceptable results (deviations mostly >3%). S-P values derived from Clarkson integration, based on published tables of phantom scatter correction factors, showed the same accuracy level as calculations performed using a pencil beam algorithm of a treatment planning system (in a homogeneous media). The separation of head scatter and phantom scatter contributions is strongly recommended for irregular MLC shaped beams as both contributions have different factors of influence. With rather simple methods S, and SP can be determined for independent MU calculation with an accuracy better than 1.5% for most clinical situations encountered in conformal radiotherapy. (C) 2004 American Association of Physicists in Medicine.

  • 27. Georg, Dietmar
    et al.
    Stock, Markus
    Kroupa, Bernhard
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ahnesjö, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Patient-specific IMRT verification using independent fluence-based dose calculation software: experimental benchmarking and initial clinical experience2007In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 52, no 16, p. 4981-4992Article in journal (Refereed)
    Abstract [en]

    Experimental methods are commonly used for patient-specific intensity-modulated radiotherapy (IMRT) verification. The purpose of this study was to investigate the accuracy and performance of independent dose calculation software ( denoted as 'MUV' ( monitor unit verification)) for patient-specific quality assurance (QA). 52 patients receiving step-and-shoot IMRT were considered. IMRT plans were recalculated by the treatment planning systems (TPS) in a dedicated QA phantom, in which an experimental 1D and 2D verification (0.3 cm(3) ionization chamber; films) was performed. Additionally, an independent dose calculation was performed. The fluence-based algorithm of MUV accounts for collimator transmission, rounded leaf ends, tongue-and-groove effect, backscatter to the monitor chamber and scatter from the flattening filter. The dose calculation utilizes a pencil beam model based on a beam quality index. DICOM RT files from patient plans, exported from the TPS, were directly used as patient-specific input data in MUV. For composite IMRT plans, average deviations in the high dose region between ionization chamber measurements and point dose calculations performed with the TPS and MUV were 1.6 +/- 1.2% and 0.5 +/- 1.1% ( 1 S. D.). The dose deviations between MUV and TPS slightly depended on the distance from the isocentre position. For individual intensity-modulated beams ( total 367), an average deviation of 1.1 +/- 2.9% was determined between calculations performed with the TPS and with MUV, with maximum deviations up to 14%. However, absolute dose deviations were mostly less than 3 cGy. Based on the current results, we aim to apply a confidence limit of 3% ( with respect to the prescribed dose) or 6 cGy for routine IMRT verification. For off-axis points at distances larger than 5 cm and for low dose regions, we consider 5% dose deviation or 10 cGy acceptable. The time needed for an independent calculation compares very favourably with the net time for an experimental approach. The physical effects modelled in the dose calculation software MUV allow accurate dose calculations in individual verification points. Independent calculations may be used to replace experimental dose verification once the IMRT programme is mature.

  • 28. Glimelius, Bengt
    et al.
    Ask, Anders
    Bjelkengren, Göran
    Björk-Eriksson, Thomas
    Blomquist, Erik
    Johansson, Bengt
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Zackrisson, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Number of patients potentially eligible for proton therapy2005In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 44, no 8, p. 836-849Article in journal (Refereed)
    Abstract [en]

    A group of Swedish radiation oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy in a facility where one of the principal aims is to facilitate randomized and other studies in which the advantage of protons can be shown and the magnitude of the differences compared with optimally administered conventional radiation treatment, also including intensity-modulated radiation therapy (IMRT) and brachytherapy, can be shown. The estimations have been based on current statistics of tumour incidence in Sweden, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours together with information on normal tissue complication rates. In Sweden, it is assessed that between 2200 and 2500 patients annually are eligible for proton beam therapy, and that for these patients the potential therapeutic benefit is so great as to justify the additional expense of proton therapy. This constitutes between 14- 15% of all irradiated patients annually.

  • 29.
    Häggström, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Axelsson, Jan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Schmidtlein, Ross
    Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York 10065, USA.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Sörensen, Jens
    Medical Sciences, Nuclear Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Larsson, Anne
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    A Monte Carlo study of the dependence of early frame sampling on uncertainty and bias in pharmacokinetic parameters from dynamic PET2015In: Journal of Nuclear Medicine Technology, ISSN 0091-4916, E-ISSN 1535-5675, Vol. 43, no 1, p. 53-60Article in journal (Refereed)
    Abstract [en]

    Compartmental modeling of dynamic PET data enables quantifi- cation of tracer kinetics in vivo, through the calculated model parameters. In this study, we aimed to investigate the effect of early frame sampling and reconstruction method on pharmacokinetic parameters obtained from a 2-tissue model, in terms of bias and uncertainty (SD). Methods: The GATE Monte Carlo software was used to simulate 2 · 15 dynamic 3′-deoxy-3′-18F-fluorothymidine (18F-FLT) brain PET studies, typical in terms of noise level and kinetic parameters. The data were reconstructed by both 3- dimensional (3D) filtered backprojection with reprojection (3DRP) and 3D ordered-subset expectation maximization (OSEM) into 6 dynamic image sets with different early frame durations of 1, 2, 4, 6, 10, and 15 s. Bias and SD were evaluated for fitted parameter estimates, calculated from regions of interest. Results: The 2-tissue-model parameter estimates K1, k2, and fraction of arterial blood in tissue depended on early frame sampling, and a sampling of 6–15 s generally minimized bias and SD. The shortest sampling of 1 s yielded a 25% and 42% larger bias than the other schemes, for 3DRP and OSEM, respectively, and a parameter uncertainty that was 10%–70% higher. The schemes from 4 to 15 s were generally not significantly different in regards to bias and SD. Typically, the reconstruction method 3DRP yielded less framesampling dependence and less uncertain results, compared with OSEM, but was on average more biased. Conclusion: Of the 6 sampling schemes investigated in this study, an early frame duration of 6–15 s generally kept both bias and uncertainty to a minimum, for both 3DRP and OSEM reconstructions. Veryshort frames of 1 s should be avoided because they typically resulted in the largest parameter bias and uncertainty. Furthermore, 3DRP may be p

  • 30.
    Häggström, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Larsson, Anne
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Östlund, Nils
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Sörensen, Jens
    Medical Sciences, Nuclear Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Semi-automatic tumour segmentation by selective navigation in a three-parameter volume, obtained by voxel-wise kinetic modelling of 11C-acetate2010In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 139, no 1-3, p. 214-218Article in journal (Refereed)
    Abstract [en]

    Positron emission tomography (PET) is increasingly used for delineation of tumour tissue in, for example, radiotherapy treatment planning. The most common method used is to outline volumes with a certain per cent uptake over background in a static image. However, PET data can also be collected dynamically and analysed by kinetic models, which potentially represent the underlying biology better. In the present study, a three-parameter kinetic model was used for voxel-wise evaluation of (11)C-acetate data of head/neck tumours. These parameters which represent the tumour blood volume, the uptake rate and the clearance rate of the tissue were derived for each voxel using a linear regression method and used for segmentation of active tumour tissue. This feasibility study shows that it is possible to segment images based on derived model parameters. There is, however, room for improvements concerning the PET data acquisition, noise reduction and the kinetic modelling. In conclusion, this early study indicates a strong potential of the method even though no 'true' tumour volume was available for validation.

  • 31.
    Häggström, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Larsson, Anne
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Axelsson, Jan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Johansson, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Schmidtlein, C. Ross
    Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
    Sörensen, Jens
    Medical Sciences, Nuclear Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    The influence of time sampling scheme on kinetic parameters obtained from compartmental modeling of a dynamic PET study: a Monte Carlo study2012In: IEEE Nuclear Science Symposium Conference Record / [ed] B. Yu, Anaheim: IEEE conference proceedings, 2012, p. 3101-3107Conference paper (Refereed)
    Abstract [en]

    Compartmental modeling of dynamic PET data enables quantification of tracer kinetics in vivo, through the obtained model parameters. The dynamic data is sorted into frames during or after the acquisition, with a sampling interval usually ranging from 10 s to 300 s. In this study we wanted to investigate the effect of the chosen sampling interval on kinetic parameters obtained from a 2-tissue model, in terms of bias and standard deviation, using a complete Monte Carlo simulated dynamic F-18-FLT PET study. The results show that the bias and standard deviation in parameter K-1 is small regardless of sampling scheme or noise in the time-activity curves (TACs), and that the bias and standard deviation in k(4) is large for all cases. The bias in V-a is clearly dependent on sampling scheme, increasing for increased sampling interval. In general, a too short sampling interval results in very noisy images and a large bias of the parameter estimate, and a too long sampling interval also increases bias. Noise in the TACs is the largest source of bias.

  • 32.
    Häggström, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Schmidtlein, C Ross
    Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Larsson, Anne
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Compartment Modeling of Dynamic Brain PET: The Effect of Scatter Corrections on Parameter Errors2014Conference paper (Other academic)
    Abstract [en]

    Purpose: To investigate the effects of corrections for random and scattered coincidences on kinetic parameters in brain tumors, by using ten Monte Carlo (MC) simulated dynamic FLT-PET brain scans.

     

    Methods: The GATE MC software was used to simulate ten repetitions of a 1 hour dynamic FLT-PET scan of a voxelized head phantom. The phantom comprised six normal head tissues, plus inserted regions for blood and tumor tissue. Different time-activity-curves (TACs) for all eight tissue types were used in the simulation and were generated in Matlab using a 2-tissue model with preset parameter values (K1,k2,k3,k4,Va,Ki). The PET data was reconstructed into 28 frames by both ordered-subset expectation maximization (OSEM) and 3D filtered back-projection (3DFBP). Five image sets were reconstructed, all with normalization and different additional corrections C (A=attenuation, R=random, S=scatter): Trues (AC), trues+randoms (ARC), trues+scatters (ASC), total counts (ARSC) and total counts (AC). Corrections for randoms and scatters were based on real random and scatter sinograms that were back-projected, blurred and then forward projected and scaled to match the real counts. Weighted non-linear-least-squares fitting of TACs from the blood and tumor regions was used to obtain parameter estimates.

     

    Results: The bias was not significantly different for trues (AC), trues+randoms (ARC), trues+scatters (ASC) and total counts (ARSC) for either 3DFBP or OSEM (p<0.05). Total counts with only AC stood out however, with an up to 160% larger bias. In general, there was no difference in bias found between 3DFBP and OSEM, except in parameter Va and Ki.

     

    Conclusion: According to our results, the methodology of correcting the PET data for randoms and scatters performed well for the dynamic images where frames have much lower counts compared to static images. Generally, no bias was introduced by the corrections and their importance was emphasized since omitting them increased bias extensively.

  • 33.
    Häggström, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Schmidtlein, C Ross
    Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York 10065.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Larsson, Anne
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Compartment modeling of dynamic brain PET: the impact of scatter corrections on parameter errors2014In: Medical physics, ISSN 0094-2405, Vol. 41, no 11, p. 111907-Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to investigate the effect of scatter and its correction on kinetic parameters in dynamic brain positron emission tomography (PET) tumor imaging. The 2-tissue compartment model was used, and two different reconstruction methods and two scatter correction (SC) schemes were investigated.

    Methods: The gate Monte Carlo (MC) softwarewas used to perform 2×15 full PET scan simulations of a voxelized head phantom with inserted tumor regions. The two sets of kinetic parameters of all tissues were chosen to represent the 2-tissue compartment model for the tracer 3′-deoxy- 3′-(18F)fluorothymidine (FLT), and were denoted FLT1 and FLT2. PET data were reconstructed with both 3D filtered back-projection with reprojection (3DRP) and 3D ordered-subset expectation maximization (OSEM). Images including true coincidences with attenuation correction (AC) and true+scattered coincidences with AC and with and without one of two applied SC schemes were reconstructed. Kinetic parameters were estimated by weighted nonlinear least squares fitting of image derived time–activity curves. Calculated parameters were compared to the true input to the MC simulations.

    Results: The relative parameter biases for scatter-eliminated data were 15%, 16%, 4%, 30%, 9%, and 7% (FLT1) and 13%, 6%, 1%, 46%, 12%, and 8% (FLT2) for K1, k2, k3, k4,Va, and Ki, respectively. As expected, SC was essential for most parameters since omitting it increased biases by 10 percentage points on average. SC was not found necessary for the estimation of Ki and k3, however. There was no significant difference in parameter biases between the two investigated SC schemes or from parameter biases from scatter-eliminated PET data. Furthermore, neither 3DRP nor OSEM yielded the smallest parameter biases consistently although therewas a slight favor for 3DRP which produced less biased k3 and Ki estimates while OSEM resulted in a less biased Va. The uncertainty in OSEM parameterswas about 26% (FLT1) and 12% (FLT2) larger than for 3DRP although identical postfilters were applied.

    Conclusions: SC was important for good parameter estimations. Both investigated SC schemes performed equally well on average and properly corrected for the scattered radiation, without introducing further bias. Furthermore, 3DRP was slightly favorable over OSEM in terms of kinetic parameter biases and SDs.

  • 34.
    Häggström, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Schmidtlein, C Ross
    Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Larsson, Anne
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Do scatter and random corrections affect the errors in kinetic parameters in dynamic PET?: a Monte Carlo study2013In: 2013 IEEE Nuclear Science Symposium and Medical Imaging Conference (2013 NSS/MIC), IEEE conference proceedings, 2013, , p. 4Conference paper (Refereed)
    Abstract [en]

    Dynamic positron emission tomography (PET) data can be evaluated by compartmental models, yielding model specific kinetic parameters. For the parameters to be of quantitative use however, understanding and estimation of errors and uncertainties associated with them are crucial.

    The aim in this study was to investigate the effects of the inclusion of scattered and random counts and their respective corrections on kinetic parameter errors.

    The MC software GATE was used to simulate two dynamic PET scans of a phantom containing three regions; blood, tissue and a static background. The two sets of time-activity-curves (TACs) used were generated for a 2-tissue compartment model with preset parameter values (K1, k2, k3, k4 and Va). The PET data was reconstructed into 19 frames by both ordered-subset expectation maximization (OSEM) and 3D filtered back-projection with reprojection (3DFBPRP) with normalization and additional corrections (A=attenuation, R=random, S=scatter, C=correction): True counts (AC), true+random counts (ARC), true+scattered counts (ASC) and total counts (ARSC).

    The results show that parameter estimates from true counts (AC), true+random counts (ARC), true+scattered counts (ASC) and total counts (ARSC) were not significantly different, with the exception of Va where the bias increased with added corrections. Thus, the inclusion of and correction for scattered and random counts did not affect the bias in parameter estimates K1, k2, k3, k4 and Ki. Uncorrected total counts (only AC) resulted in biases of hundreds or even thousands of percent, emphasizing the need for proper corrections. Reconstructions with 3DFBPRP resulted in overall 20-40% less biased estimates compared to OSEM.

  • 35.
    Johansson, Adam
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Improved quality of computed tomography substitute derived from magnetic resonance (MR) data by incorporation of spatial information: potential application for MR-only radiotherapy and attenuation correction in positron emission tomography2013In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 52, no 7, p. 1369-1373Article in journal (Refereed)
    Abstract [en]

    Background: Estimation of computed tomography (CT) equivalent data, i.e. a substitute CT (s-CT), from magnetic resonance (MR) images is a prerequisite both for attenuation correction of positron emission tomography (PET) data acquired with a PET/MR scanner and for dose calculations in an MR-only radiotherapy workflow. It has previously been shown that it is possible to estimate Hounsfield numbers based on MR image intensities, using ultra short echo-time imaging and Gaussian mixture regression (GMR). In the present pilot study we investigate the possibility to also include spatial information in the GMR, with the aim to improve the quality of the s-CT. Material and methods: MR and CT data for nine patients were used in the present study. For each patient, GMR models were created from the other eight patients, including either both UTE image intensities and spatial information on a voxel by voxel level, or only UTE image intensities. The models were used to create s-CT images for each respective patient. Results: The inclusion of spatial information in the GMR model improved the accuracy of the estimated s-CT. The improvement was most pronounced in smaller, complicated anatomical regions as the inner ear and post-nasal cavities. Conclusions: This pilot study shows that inclusion of spatial information in GMR models to convert MR data to CT equivalent images is feasible. The accuracy of the s-CT is improved and the spatial information could make it possible to create a general model for the conversion applicable to the whole body.

  • 36.
    Johansson, Adam
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    CT substitute derived from MRI sequences with ultrashort echo time2011In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 38, no 5, p. 2708-2714Article in journal (Refereed)
    Abstract [en]

    Purpose: Methods for deriving computed tomography (CT) equivalent information from MRI are needed for attenuation correction in PET/MRI applications, as well as for patient positioning and dose planning in MRI based radiation therapy workflows. This study presents a method for generating a drop in substitute for a CT image from a set of magnetic resonance (MR)images.

    Methods:A Gaussian mixture regression model was used to link the voxel values in CT images to the voxel values in images from three MRI sequences: one T2 weighted 3D spin echo based sequence and two dual echo ultrashort echo time MRI sequences with different echo times and flip angles. The method used a training set of matched MR and CT data that after training was able to predict a substitute CT (s-CT) based entirely on the MR information for a new patient. Method validation was achieved using datasets covering the heads of five patients and applying leave-one-out cross-validation (LOOCV). During LOOCV, the model was estimated from the MR and CT data of four patients (training set) and applied to the MR data of the remaining patient (validation set) to generate an s-CT image. This procedure was repeated for all five training and validation data combinations.

    Results: The mean absolute error for the CT number in the s-CT images was 137 HU. No large differences in method accuracy were noted for the different patients, indicating a robust method. The largest errors in the s-CT images were found at air–tissue and bone–tissue interfaces. The model accurately discriminated between air and bone, as well as between soft tissues and nonsoft tissues.

    Conclusions: The s-CT method has the potential to provide an accurate estimation of CT information without risk of geometrical inaccuracies as the model is voxel based. Therefore, s-CT images could be well suited as alternatives to CT images for dose planning in radiotherapy and attenuation correction in PET/MRI.

  • 37.
    Johansson, Adam
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Yu, Jun
    SLU, Centre of Biostochastics.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Voxel-wise uncertainty in CT substitute derived from MRI2012In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 39, no 6, p. 3283-3290Article in journal (Refereed)
    Abstract [en]

    Purpose: In an earlier work, we demonstrated that substitutes for CT images can be derived from MR images using ultrashort echo time (UTE) sequences, conventional T2 weighted sequences, and Gaussian mixture regression (GMR). In this study, we extend this work by analyzing the uncertainties associated with the GMR model and the information contributions from the individual imaging sequences.

    Methods: An analytical expression for the voxel-wise conditional expected absolute deviation (EAD) in substitute CT (s-CT) images was derived. The expression depends only on MR images and can thus be calculated along with each s-CT image. The uncertainty measure was evaluated by comparing the EAD to the true mean absolute prediction deviation (MAPD) between the s-CT and CT images for 14 patients. Further, the influence of the different MR images included in the GMR model on the generated s-CTs was investigated by removing one or more images and evaluating the MAPD for a spectrum of predicted radiological densities.

    Results: The largest EAD was predicted at air-soft tissue and bone-soft tissue interfaces. The EAD agreed with the MAPD in both these regions and in regions with lower EADs, such as the brain. Two of the MR images included in the GMR model were found to be mutually redundant for the purpose of s-CT generation.

    Conclusions: The presented uncertainty estimation method accurately predicts the voxel-wise MAPD in s-CT images. Also, the non-UTE sequence previously used in the model was found to be redundant.

  • 38.
    Jonsson, Joakim H
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Brynolfsson, Patrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Söderström, Karin
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Registration accuracy for MR images of the prostate using a subvolume based registration protocol2011In: Radiation Oncology, ISSN 1748-717X, E-ISSN 1748-717X, Vol. 6, no 1, p. 73-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In recent years, there has been a considerable research effort concerning the integration of magnetic resonance imaging (MRI) into the external radiotherapy workflow motivated by the superior soft tissue contrast as compared to computed tomography. Image registration is a necessary step in many applications, e.g. in patient positioning and therapy response assessment with repeated imaging. In this study, we investigate the dependence between the registration accuracy and the size of the registration volume for a subvolume based rigid registration protocol for MR images of the prostate.

    METHODS: Ten patients were imaged four times each over the course of radiotherapy treatment using a T2 weighted sequence. The images were registered to each other using a mean square distance metric and a step gradient optimizer for registration volumes of different sizes. The precision of the registrations was evaluated using the center of mass distance between the manually defined prostates in the registered images. The optimal size of the registration volume was determined by minimizing the standard deviation of these distances.

    RESULTS: We found that prostate position was most uncertain in the anterior-posterior (AP) direction using traditional full volume registration. The improvement in standard deviation of the mean center of mass distance between the prostate volumes using a registration volume optimized to the prostate was 3.9 mm (p < 0.001) in the AP direction. The optimum registration volume size was 0 mm margin added to the prostate gland as outlined in the first image series.

    CONCLUSIONS: Repeated MR imaging of the prostate for therapy set-up or therapy assessment will both require high precision tissue registration. With a subvolume based registration the prostate registration uncertainty can be reduced down to the order of 1 mm (1 SD) compared to several millimeters for registration based on the whole pelvis.

  • 39.
    Jonsson, Joakim H
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Magnus G
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Treatment planning using MRI data: an analysis of the dose calculation accuracy for different treatment regions2010In: Radiation Oncology, ISSN 1748-717X, E-ISSN 1748-717X, Vol. 5, p. 62-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Because of superior soft tissue contrast, the use of magnetic resonance imaging (MRI) as a complement to computed tomography (CT) in the target definition procedure for radiotherapy is increasing. To keep the workflow simple and cost effective and to reduce patient dose, it is natural to strive for a treatment planning procedure based entirely on MRI. In the present study, we investigate the dose calculation accuracy for different treatment regions when using bulk density assignments on MRI data and compare it to treatment planning that uses CT data.

    METHODS: MR and CT data were collected retrospectively for 40 patients with prostate, lung, head and neck, or brain cancers. Comparisons were made between calculations on CT data with and without inhomogeneity corrections and on MRI or CT data with bulk density assignments. The bulk densities were assigned using manual segmentation of tissue, bone, lung, and air cavities.

    RESULTS: The deviations between calculations on CT data with inhomogeneity correction and on bulk density assigned MR data were small. The maximum difference in the number of monitor units required to reach the prescribed dose was 1.6%. This result also includes effects of possible geometrical distortions.

    CONCLUSIONS: The dose calculation accuracy at the investigated treatment sites is not significantly compromised when using MRI data when adequate bulk density assignments are made. With respect to treatment planning, MRI can replace CT in all steps of the treatment workflow, reducing the radiation exposure to the patient, removing any systematic registration errors that may occur when combining MR and CT, and decreasing time and cost for the extra CT investigation.

  • 40.
    Karlsson, M G
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Electron beam collimation with focused and curved leaf end MLCs - Experimental verification of Monte Carlo optimized designs2002In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 29, no 4, p. 631-637Article in journal (Refereed)
    Abstract [en]

    In general, electron beams, from conventional accelerators using applicators with lead alloy inserts are not suitable for advanced conformal radiation therapy. However, interesting electron treatments have been demonstrated on a few advanced accelerators. These accelerators have been equipped with helium filled treatment heads and computer controlled MLCs that produce clinically useful energy modulated electron beams or mixed photon electron beams in an automated sequence. This study analyzes the characteristics of different MLC designs, curved and focused leaf ends in helium filled treatment heads, with respect to their effect on electron beams. In addition, this study analyzes the effects that different treatment head designs have on the output factor due to collimator scattering and shielding of secondary sources during treatment. The investigation of the different treatment head designs was performed with the Monte Carlo package BEAM and was verified by experimental methods. The results show that the difference between curved leaf ends and focused ends is negligible in most practical cases. The results also show the importance of scattering foil optimization in the optimization of parameters such as penumbra. virtual source position, and in the reduction of the output variation. In all cases, the experimental data verifies the calculations. (C) 2002 American Association of Physicists in Medicine.

  • 41.
    Karlsson, M G
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ma, C M
    Treatment head design for multileaf collimated high-energy electrons1999In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 26, no 10, p. 2161-2167Article in journal (Refereed)
    Abstract [en]

    This paper describes how a conventional treatment head can be modified for use of multileaf collimated electron beams. Automatic and dynamic beam delivery are possible for both electrons and photons by using the computer controlled multileaf collimator (MLC) for both photon and electron beams. Thereby, the electron beams can be mixed more freely into the treatment to take advantage of the specific depth modulation characteristics of electrons. The investigation was based on Monte Carlo calculations using the software package BEAM. The physical parameters used in this optimization were the beam penumbra and the virtual/effective point source position. These parameters are essential for shaping beams, beam matching and for dosimetry calculations. The optimization was carried out by modifying a number of parameters: replacing the air atmosphere in the treatment head with helium, adding a helium bag below the MLC, changing the position of the scattering foils, modifying the monitor chamber, and adjusting the position of the MLC. The beam characteristics for some of these designs were found to fulfil our criteria for clinically useful beams down to at least 9 MeV. (C) 1999 American Association of Physicists in Medicine. [S0094-2405(99)00610-0].

  • 42.
    Karlsson, Magnus G
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Sjögren, Rickard
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Svensson, Hans
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Semi-conductor detectors in output factor measurements1997In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 42, no 3, p. 293-296Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Output factors are generally measured with cylindrical ionization chambers. It was investigated if Si-diodes of p-type instead could be used. The advantage would be the small detector size and the robust construction of the detector.

    Materials and methods: Two types of diodes were studied, one with a shielding layer of tungsten specially made to reduce the excess response for scattered photons and one standard diode without any extra shielding. The measurements were performed at accelerating potentials between 4 and 50 MV and beam sizes between 4 cm x 4 cm and 40 cm x 40 cm.

    Results: The results showed that both types of diodes are suitable for measurements of head scatter factors in mini-phantoms. However, the diodes were found inappropriate for measurement of output factors for large fields in extended water phantoms. For small fields (<10 cm x 10 cm) a small detector is advantageous and no errors due to the scatter contribution were seen.

    Conclusions: An cylindrical ionization chamber is the best choice for output factor measurements in extended water phantoms for large field sizes while diodes are an alternative in small fields. There were negligible differences between the detectors in head scatter measurements in mini phantoms.

  • 43.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    A multileaf delineator system for a radiotherapy simulator1994In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 21, no 1, p. 83-84Article in journal (Refereed)
    Abstract [en]

    Multileaf collimators are offered as an accessory to many accelerators for conformal radiotherapy and the dose planning systems are capable of calculating multileaf collimated beams. There is further a frequent desire to verify the radiation fields on a radiotherapy simulator prior to the actual treatment. For this purpose,an accessory to the simulator was developed (the multileaf delineator). With this unit the front end of the individual leaves are indicated both on the skin of the patient and in the x-ray image. All anatomical structures both outside and inside the field edge are, however, still fully visible.

  • 44.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    A study of some energy dependent characteristics of X-ray screens used in diagnostic radiology: screen-film sensitivity, MTF and some related factors1983Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Fluorescent x-ray screens are used in medical x-ray diagnostics to absorb x-ray photons and convert these x-ray photons to visible light. The light distribution from these screens are then registered on photographic film to give an x-ray image. Both the sensitivity and the resolution characteristics of these systems are dependent on the x-ray photon energy. To enable a study of these and some other energy dependent characteristics of x-ray screens a number of almost monoener-getic radiation sources were constructed, tested with regard to their purity and calibrated. Both film and a photo-multiplier tube were used as light detectors.The sensitivity of screens with three different screen phosphors were studied as a function of the photon energy and large variations in sensitivity was found for different photon energies and screen phosphors. The light from the screens has been compared to the absorbed energy in the screens and this comparison shows that the energy dependence of the screens can approximately be predicted by calculations of the absorbed energy, except at low photon energies where other effects like increased light absorption in the screens is present.The modulation transfer factor (MTF) was studied both experimentally and theoretically as a function of photon energy. Two effects were shown to influence the energy dependence of the MTF. At low energies an increased light diffusion will destroy the MTF and at energies above the K-edge of the high-Z elements in the screens the production and re-absorption of K-radiation will deteriorate the MTF.Both the energy dependence of the screen-film sensitivity and the MTF have been calculated for some normally used spectral distributions from x-ray tubes and significant changes due to choice of kV and filtration of the beam were found. Other effects such as the number of interacting photons in the screens per unit area, contribution of K-radiation from one screen to the other, and light contribution to the front emulsion of the film compared to the back emulsion have also been investigated as a function of photon energy.Optimization of x-ray systems and clinical routines to give the lowest possible radiation dose to the patient with an acceptable image quality is an important task to carry out. The energy dependent characteristi es of x-ray screens studied in this work is a lead in the optimizing of the system with regard to choice of x-ray screens, film and radiation quality.

  • 45.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ahnesjö, Anders
    Department of Oncology, Radiology and Clinical Immunology, Uppsala.
    Georg, Dietmar
    Division Medical Radiation Physics, Department of Radiotherapy, Medical.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Beam modelling and dose calculations2010In: Independent Dose Calculations - Concepts and Models: Booklet 10, Bryssel: ESTRO , 2010, 1, p. 39-66Chapter in book (Other academic)
  • 46.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ahnesjö, Anders
    Department of Oncology, Radiology and Clinical Immunology, Uppsala.
    Georg, Dietmar
    Division Medical Radiation Physics, Department of Radiotherapy, Medical.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Dosimetric tolerance limits and action limits2010In: Independent Dose Calculations - Concepts and Models: Booklet 10, Bryssel: ESTRO , 2010, 1, p. 13-24Chapter in book (Other academic)
  • 47.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ahnesjö, Anders
    Department of Oncology, Radiology and Clinical Immunology, Uppsala.
    Georg, Dietmar
    Division Medical Radiation Physics, Department of Radiotherapy, Medical.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Measured data for verification and dose calculations2010In: Independent Dose Calculations - Concepts and Models: Booklet 10, Bryssel: ESTRO , 2010, 1, p. 67-76Chapter in book (Other academic)
  • 48.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ahnesjö, Anders
    Department of Oncology, Radiology and Clinical Immunology, Uppsala.
    Georg, Dietmar
    Division Medical Radiation Physics, Department of Radiotherapy, Medical.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Statistical analysis2010In: Independent Dose Calculations - Concepts and Models: Booklet 10, Bryssel: ESTRO , 2010, 1, p. 25-38Chapter in book (Other academic)
  • 49.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ahnesjö, Anders
    Department of Oncology, Radiology and Clinical Immunology, Uppsala.
    Georg, Dietmar
    Division Medical Radiation Physics, Department of Radiotherapy, Medical.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    The concept of independent dose calculation2010In: Independent Dose Calculations - Concepts and Models: Booklet 10, Mounierlaan 83/12 – 1200 Brussels (Belgium): ESTRO , 2010, 1, p. 5-12Chapter in book (Other academic)
  • 50.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Radiation Sciences, Radiation Physics.
    Björk-Eriksson, Thomas
    Mattsson, Olof
    Mattsson, Sören
    Montelius, Anders
    Nilsson, Per
    Zackrisson, Björn
    Umeå University, Faculty of Medicine, Radiation Sciences, Oncology.
    Distributed proton radiation therapy - A new concept for advance competence support2006In: Acta Oncologica, ISSN 0284-186X, Vol. 45, no 8, p. 1094-1101Article in journal (Refereed)
123 1 - 50 of 112
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