Though mammography is one of the most sensitive methods to detect breast cancer, the benefit of the mammography screening programmes is still not clearly proven. One of the reasons is the radiation dose delivered by the examinations. Simulations of the radiation transport based on realistic breast phantoms are a useful tool to estimate the dose for the risk relevant parenchymal tissue. Specimens of real breasts have been fixated using a specially designed process while being compressed as in mammography. They have been scanned using the high-resolution mode of a CT. A segmentation has been carried out by assigning the voxels to different tissues. The resulting voxel phantom allows the assessment of tissue doses by Monte-Carlo calculations and can be used to simulate the diagnostic outcome of different imaging procedures. Three different tissues were separated: skin, adipose and ‘breast tissue’. This allows reasonable calculations of the average glandular doses in mammography.

Former studies by Hoeschen and Buhr indicated a higher total noise in a thorax image than expected from technical noise, i.e. quantum and detector noise. This difference results from the overlay of many small anatomical structures along the X-ray beam, which leads to a noise-like appearance without distinguishable structures in the projected image. A method is proposed to quantitatively determine this ‘anatomical noise’ component, which is not to be confused with the anatomical background (e.g. ribs). This specific anatomical noise pattern in a radiograph changes completely when the imaging geometry changes because different small anatomical structures contribute to the projected image. Therefore, two images are taken using slightly different exposure geometry, and a correlation analysis based on wavelet transforms allows to determining the uncorrelated noise components. Since the technical noise also differs from image to image, which makes it difficult to separate the anatomical noise, images of a lung phantom were produced on a low-sensitive industrial X-ray film using high-exposure levels. From these results, the anatomical noise level in real clinical thorax radiographs using realistic exposure levels is predicted using the general dose dependence described in the paper text and compared with the quantum and detector noise level of an indirect flat-panel detector system. For consistency testing, the same lung phantom was imaged with the same digital flat-panel detector and the total image noise including anatomical noise is determined. The results show that the relative portion of anatomical noise may exceed the technical noise level. Anatomical noise is an important contributor to the total image noise and, therefore, impedes the recognition of anatomical structures.

Dose coefficients of radiopharmaceuticals have been published by the International Commission on Radiological Protection (ICRP) and the Medical Internal Radiation Dose (MIRD) Committee, but without information concerning uncertainties. The uncertainty information of dose coefficients is important, for example, to compare alternative diagnostic methods and choose the method that causes the lowest patient exposure with appropriate and comparable diagnostic quality. For the study presented here, an uncertainty analysis method was developed and used to calculate the uncertainty of the internal doses of seven common radiopharmaceuticals. Methods: On the basis of the generalized schema of dose calculation recommended by ICRP and the MIRD Committee, an analysis based on propagation of uncertainty was developed and applied for seven radiopharmaceuticals. The method takes into account the uncertainties contributed from pharmacokinetic models and the so-called S values derived from several voxel computational phantoms previously developed at Helmholtz Zentrum München. Random and Latin hypercube sampling techniques were used to sample parameters of pharmacokinetic models and S values, and the uncertainties of absorbed doses and effective doses were calculated. Results: The uncertainty factors (square root of ratio between 97.5th and 2.5th percentiles) for organ absorbed doses are in the range of 1.1 to 3.3. Uncertainty values of effective doses are lower in comparison to absorbed doses, the maximum value being approximately 1.4. The ICRP reference values showed a deviation comparable to the effective dose calculated in this study. Conclusion: A general statistical method was developed for calculating the uncertainty of absorbed doses and effective doses for seven radiopharmaceuticals. The dose uncertainties can be used to further identify the most important parameters in the dose calculation and provide reliable dose coefficients for risk analysis of the patients in nuclear medicine.

A novel method of noise reduction has been tested for mammography using computer-simulated images for which the truth is known exactly. This method is based on comparing two images. The images are compared at different scales, using a cross-correlation function as a measure of similarity to define the image modifications in the wavelet domain. The computer-simulated images were calculated for noise-free primary radiation using a quasi-realistic voxel phantom. Two images corresponding to slightly different geometry were produced. Gaussian noise was added with certain properties to simulate quantum noise. The added noise could be reduced by >70% using the proposed method without any noticeable corruption of the structures. It is possible to save 50% dose in mammography by producing two images (each 25% of the dose for a standard mammogram). Additionally, a reduction of the anatomical noise and, therefore, better detection rates of breast cancer in mammography are possible.

Gold nanoparticles (GNPs) were demonstrated as X-ray imaging contrast agents and radiosensitizers in mice. However, the translational medical applications of GNPs in to the clinical practice need further detailed information on the biological effects related to the enhanced doses in malignant and healthy cells. The idea of improving radiotherapy with high atomic number materials, especially gold foils, was initiated in our research unit in the 1980s. Recently, experimental and theoretical efforts were made to investigate the potential improvement of imaging and radiotherapy with GNPs. Initially, the present work attempts to validate the dose enhancement effects of GNPs to cancer cells; secondly, it intends to examine the possible side effects on healthy cells when using GNPs as X-ray contrast agent. In this study, three Monte Carlo simulation programs, namely PENELOPE-2011, GEANT4 and EGSnrc were used to simulate the local energy deposition and the resulting dose enhancement of GNPs. Diameters of the GNPs were assumed to be 2 nm, 15 nm, 50 nm, 100 nm and 200 nm. The X-ray energy spectra for irradiation were 60 kVp, 80 kVp, 100 kVp, 150 kVp with a filtering of 2.7 mm Al for projectional radiography, and 8 mm Al for 100 kVp and 150 kVp for computed tomography. Additional peak energy of 200 kVp was simulated for radiotherapy purpose. The information of energy deposition and dose enhancement can help understanding the physical processes of medical imaging and the implication of nanoparticles in radiotherapy.

We propose a novel x-ray fluorescence imaging setup for the in vivo detection of high-Z tracer distributions. The main novel aspect is the use of an analyzer-based, energy-resolved detection method together with a radial, scatter reducing collimator. The aim of this work is to show the feasibility of this method by measuring the Bragg reflected K-fluorescence signal of an iodine solution sample in a proof of principle experiment and to estimate the potential of the complete imaging setup using a Monte Carlo simulation, including a quantification of the minimal detectable tracer concentration for in vivo imaging. The proof of principle experiment shows that even for a small detector area of approximately 7 mm2, the collimated and Bragg reflected K-fluorescence signal of a sample containing an iodine solution with a concentration of 50 µg ml−1 can be detected. The Monte Carlo simulation also shows that the proposed x-ray fluorescence imaging setup has the potential to image distributions of high-Z tracers in vivo at a radiation dose of a few mGy and at tracer concentrations down to 1 µg ml−1 for iodine in small animals.