Monte Carlo-based patient internal dosimetry in fluoroscopy-guided interventional procedures: A review

Fum, Wilbur K. S. and Wong, Jeannie Hsiu Ding and Tan, Li Kuo (2021) Monte Carlo-based patient internal dosimetry in fluoroscopy-guided interventional procedures: A review. Physica Medica-European Journal of Medical Physics, 84. pp. 228-240. ISSN 1120-1797, DOI

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Purpose: This systematic review aims to understand the dose estimation approaches and their major challenges. Specifically, we focused on state-of-the-art Monte Carlo (MC) methods in fluoroscopy-guided interventional procedures. Methods: All relevant studies were identified through keyword searches in electronic databases from inception until September 2020. The searched publications were reviewed, categorised and analysed based on their respective methodology. Results: Hundred and one publications were identified which utilised existing MC-based applications/programs or customised MC simulations. Two outstanding challenges were identified that contribute to uncertainties in the virtual simulation reconstruction. The first challenge involves the use of anatomical models to represent individuals. Currently, phantom libraries best balance the needs of clinical practicality with those of specificity. However, mismatches of anatomical variations including body size and organ shape can create significant discrepancies in dose estimations. The second challenge is that the exact positioning of the patient relative to the beam is generally unknown. Most dose prediction models assume the patient is located centrally on the examination couch, which can lead to significant errors. Conclusion: The continuing rise of computing power suggests a near future where MC methods become practical for routine clinical dosimetry. Dynamic, deformable phantoms help to improve patient specificity, but at present are only limited to adjustment of gross body volume. Dynamic internal organ displacement or reshaping is likely the next logical frontier. Image-based alignment is probably the most promising solution to enable this, but it must be automated to be clinically practical.

Item Type: Article
Funders: Fundamental Research Grant Scheme (FRGS) (FRGS/1/2020/SKK0/UM/02/30), Ministry of Education, Malaysia
Uncontrolled Keywords: Interventional radiological procedures; Patient organ dosimetry; Fluoroscopy-guided; Monte Carlo methods
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine > Biomedical Imaging Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 31 May 2022 01:31
Last Modified: 31 May 2022 01:31

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