Single-photon emission computed tomography (SPECT)-based tracers are easily available and more widely used than positron emission tomography (PET)-based tracers, and SPECT imaging still remains the most prevalent nuclear medicine imaging modality worldwide. The aim of this study is to implement an image-based Monte Carlo method for patient-specific three-dimensional (3D) absorbed dose calculation in patients after injection of 99mTc-hydrazinonicotinamide (hynic)-Tyr3-octreotide as a SPECT radiotracer. 99mTc patient-specific S values and the absorbed doses were calculated with GATE code for each source-target organ pair in four patients who were imaged for suspected neuroendocrine tumors. Each patient underwent multiple whole-body planar scans as well as SPECT imaging over a period of 1-24 h after intravenous injection of 99mhynic-Tyr3-octreotide. The patient-specific S values calculated by GATE Monte Carlo code and the corresponding S values obtained by MIRDOSE program differed within 4.3% on an average for self-irradiation, and differed within 69.6% on an average for cross-irradiation. However, the agreement between total organ doses calculated by GATE code and MIRDOSE program for all patients was reasonably well (percentage difference was about 4.6% on an average). Normal and tumor absorbed doses calculated with GATE were slightly higher than those calculated with MIRDOSE program. The average ratio of GATE absorbed doses to MIRDOSE was 1.07 ± 0.11 (ranging from 0.94 to 1.36). According to the results, it is proposed that when cross-organ irradiation is dominant, a comprehensive approach such as GATE Monte Carlo dosimetry be used since it provides more reliable dosimetric results.

Radiotherapy dose calculations can be evaluated by Monte Carlo (MC) simulations with acceptable accuracy for dose prediction in complicated treatment plans. In this work, Standard, Livermore and Penelope electromagnetic (EM) physics packages of GEANT4 application for tomographic emission (GATE) 6.1 were compared versus Monte Carlo N-Particle eXtended (MCNPX) 2.6 in simulation of 6 MV photon Linac. To do this, similar geometry was used for the two codes. The reference values of percentage depth dose (PDD) and beam profiles were obtained using a 6 MV Elekta Compact linear accelerator, Scanditronix water phantom and diode detectors. No significant deviations were found in PDD, dose profile, energy spectrum, radial mean energy and photon radial distribution, which were calculated by Standard and Livermore EM models and MCNPX, respectively. Nevertheless, the Penelope model showed an extreme difference. Statistical uncertainty in all the simulations was <1%, namely 0.51%, 0.27%, 0.27% and 0.29% for PDDs of 10 cm2× 10 cm2 filed size, for MCNPX, Standard, Livermore and Penelope models, respectively. Differences between spectra in various regions, in radial mean energy and in photon radial distribution were due to different cross section and stopping power data and not the same simulation of physics processes of MCNPX and three EM models. For example, in the Standard model, the photoelectron direction was sampled from the Gavrila-Sauter distribution, but the photoelectron moved in the same direction of the incident photons in the photoelectric process of Livermore and Penelope models. Using the same primary electron beam, the Standard and Livermore EM models of GATE and MCNPX showed similar output, but re-tuning of primary electron beam is needed for the Penelope model.

GATE is a simulation code which is based on the Geant4 Monte Carlo code. This code was developed for simulation of nuclear medicine imaging systems. Our aim in this study was to use and validate GATE for simulating a Siemens E.Cam gamma camera. A dual-head gamma camera was used for modeling with GATE. Each head consisted of a collimator, aluminum layer, crystal, and head shielding. The back compartment consisted of photomultiplier tubes and electronic circuits behind the crystal. The photoelectric effect and Compton and Rayleigh scatter were included in the gamma transport process. The simulation validity was examined by comparison of measured parameters with calculated data including the energy spectrum, energy, spatial resolution, and sensitivity. To evaluate the imaging system, we compared the simulated and experimental images of a phantom. The simulated and measured energy spectra agreed well with regard to the position and height of the photopeak at 140 keV. The FWHMs at 140 keV were calculated to be equal to 14.10 and 13.37 keV, respectively. The energy resolutions were 10.07 and 9.55%, and the sensitivities were 8.68 × 10(-5) and 8.69 × 10(-5) cps/MBq, respectively, for the simulated and measured results. The spatial resolution and imaging tests for a point, line, and node phantom showed good agreement between the simulated and measured results. Overall, the results showed good agreement between the measured and the simulated data. There was also excellent agreement between computational and actual images. This study demonstrated the flexibility and accuracy of GATE in SPECT simulation.

Monte Carlo techniques are widely employed in internal dosimetry to obtain better estimates of absorbed dose distributions from irradiation sources in medicine. Accurate 3D absorbed dosimetry would be useful for risk assessment of inducing deterministic and stochastic biological effects for both therapeutic and diagnostic radiopharmaceuticals in nuclear medicine. The goal of this study was to experimentally evaluate the use of Geant4 application for tomographic emission (GATE) Monte Carlo package for 3D internal dosimetry using the head portion of the RANDO phantom. GATE package (version 6.1) was used to create a voxel model of a human head phantom from computed tomography (CT) images. Matrix dimensions consisted of 319 × 216 × 30 voxels (0.7871 × 0.7871 × 5 mm(3)). Measurements were made using thermoluminescent dosimeters (TLD-100). One rod-shaped source with 94 MBq activity of (99m)Tc was positioned in the brain tissue of the posterior part of the human head phantom in slice number 2. The results of the simulation were compared with measured mean absorbed dose per cumulative activity (S value). Absorbed dose was also calculated for each slice of the digital model of the head phantom and dose volume histograms (DVHs) were computed to analyze the absolute and relative doses in each slice from the simulation data. The S-values calculated by GATE and TLD methods showed a significant correlation (correlation coefficient, r(2) ≥ 0.99, p < 0.05) with each other. The maximum relative percentage differences were ≤14% for most cases. DVHs demonstrated dose decrease along the direction of movement toward the lower slices of the head phantom. Based on the results obtained from GATE Monte Carlopackage it can be deduced that a complete dosimetry simulation study, from imaging to absorbed dose map calculation, is possible to execute in a single framework.

The present study was conducted to compare dosimetric parameters for the heart and left lung between free breathing (FB) and deep inspiration breath hold (DIBH) and determine the most important potential factors associated with increasing the lung dose for left-sided breast radiotherapy using image analysis with 3D Slicer software. Materials and Methods: Computed tomography-simulation scans in FB and DIBH were obtained from 17 patients with left-sided breast cancer. After contouring, three-dimensional conformal plans were generated for them. The prescribed dose was 50 Gy to the clinical target volume. In addition to the dosimetric parameters, the irradiated volumes and both displacement magnitudes and vectors for the heart and left lung were assessed using 3D Slicer software. Results: The average of the heart mean dose (D mean) decreased from 5.97 to 3.83 Gy and V 25 from 7.60% to 3.29% using DIBH (p < 0.001). Furthermore, the average of D mean for the left lung was changed from 8.67 to 8.95 Gy (p = 0.389) and V 20 from 14.84% to 15.44% (p = 0.387). Both of the absolute and relative irradiated heart volumes decreased from 42.12 to 15.82 mL and 8.16% to 3.17%, respectively (p < 0.001); however, these parameters for the left lung increased from 124.32 to 223.27 mL (p < 0.001) and 13.33% to 13.99% (p = 0.350). In addition, the average of heart and left lung displacement magnitudes were calculated at 7.32 and 20.91 mm, respectively. Conclusion: The DIBH is an effective technique in the reduction of the heart dose for tangentially treated left sided-breast cancer patients, without a detrimental effect on the left lung.