NCIDOSE is a collection of medical radiation dosimetry tools developed by radiation physicists from the National Cancer Institute (NCI), Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch. These tools can be used to estimate the radiation organ doses received by patients undergoing diagnostic or therapeutic procedures. The resources are the product of years of research and development in collaboration with a number of institutions, much of which has been published in the peer-reviewed literature. As a governmental resource these tools are available to the public free-of-charge for non-commercial research purposes.
The following resources are currently available:
- PHANTOMS, three-dimensional computational human anatomy models
- NCICT, NCI dosimetry system for Computed Tomography
- NCINM, NCI dosimetry system for Nuclear Medicine
- NCIRF, NCI dosimetry system for Radiography and Fluoroscopy
- Dose Conversion Coefficients
How Can I Request These Resources?
Non-Commercial Research Use
There is no charge to use for non-commercial research purposes. Please submit a Software Transfer Agreement form to Dr. Choonsik Lee and NCI Technology Transfer Center (email@example.com)
Commercial or Other Use
Contact Dr. Kevin Chang of the NCI Technology Transfer Center to discuss the licensing process.
Three-dimensional computerized representations of the human body, referred to as computational phantoms, have been used in the fields of medical physics and radiation protection for decades to study people exposed to medical, occupational, and environmental radiation. PHANTOMS is a library of state-of-the-art whole-body computational phantoms representing children and adults of different body height and weight. Each phantom contains more than 100 carefully delineated organs or tissues.
The PHANTOMS library was developed from x-ray computed tomography (CT) images of patients and was the product of a collaboration between the University of Florida and National Cancer Institute.1,2 Best quality anatomical reference CT images were selected from an archive of 1,000+ patients. More than 100 organs and tissues were manually segmented and reviewed by practicing radiologists. The original PHANTOMS library consisted of a series of reference male and female anatomies (newborn, 1-, 5-, 10-, 15-year-old, and adult). This library was later extended to 370 phantoms representing children and adults of both genders and various heights and weights.2 NCI researchers also added anatomical details such as lymphatic nodes3,4, substructures of the heart (e.g. atria, ventricles, arteries), and substructures of the brain (e.g. grey and white matter, cerebellum, brain stem).5
The PHANTOMS library was carefully adjusted to match several international reference data including reference person height and weight6, organ mass6, tissue elemental composition6,7, and dimensions of gastrointestinal structures8. The pediatric phantoms have been adopted by International Commission on Radiological Protection (ICRP) as the international reference.
STATE-OF-THE-ART AND VERSITLE FORMAT
The PHANTOMS library was developed using mesh and non-uniform rational B-spline (NURBS) surfaces, the most advanced phantom architecture to date. The phantoms can be converted into voxel format compatible with most Monte Carlo radiation transport codes such as MCNPX, MCNP6, EGSnrc, GEANT4, PHITS. Input decks for these codes describing the phantoms are also available for release. Some Monte Carlo codes can import the original surface geometry format.
Simulated CT images have been derived for the entire PHANTOMS library and are written in Digital Imaging and Communications in Medicine (DICOM) CT format. An accompanying DICOM Structure file contains the contours for more than 100 structures included in the phantom. These files have been tested for compatibility on several commercial radiotherapy treatment planning systems (TPS). After importing into a TPS, users can create a treatment plan on the phantom CT and evaluate dose to organs of interest.
Over the last three decades, the number of computed tomography (CT) examinations conducted annually has grown exponentially such that CT imaging currently represents about a quarter of the collective effective dose received by the U.S. population. To address this public health concern, it is important to have tools to assess and monitor radiation exposures from CT scans. NCICT, the National Cancer Institute dosimetry system for Computed Tomography,9 is an easy-to-use CT organ dose calculator.
The program provides absorbed dose to major radiosensitive organs and tissues based on the characteristics of patients and CT scan parameters. NCICT combines several cutting-edge technologies including a library of computational human phantoms, the simulation of x-rays from a reference CT scanner, and a user-friendly graphical interface. The simulated dose results have been rigorously validated through comparison with experimental measurement.10-12
The NCICT software incorporates state-of-the-art phantoms, with enough variety to represent just about any patient. NCICT includes the following phantoms: the International Commission on Radiological Protection (ICRP) reference pediatric and adult series (NCICT 1.0), the PHANTOMS library of 370 pediatric and adult males and females of different height and weight (NCICT 2.0), and eight pregnant phantoms containing detailed fetus models at various gestations (NCICT 3.0).13
NCICT is a standalone software which runs on a personal computer. Users do not need an internet connection to upload sensitive patient data to a central server. NCICT works on multiple platforms including Windows, Mac, and LINUX.
VERSATILE DOSE CALCULATION MODES
NCICT features two computation modes: Graphical User Interface (GUI) mode and Batch Calculation mode. The GUI mode allows the user to interactively enter patient and CT scanner data and NCICT rapidly calculates organ doses with simple graphs. The Batch Calculation mode is designed to compute organ doses for a large number of patients by importing a set of parameters from a formatted text file. The Batch Calculation mode also runs by text command, making it easy to connect NCICT with existing databases.
NCICT was rigorously tested by more than 100 beta users whose feedback were incorporated into several revisions. The software has been used by hundreds of users worldwide and has resulted in many research publications.14-29
Advances in Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) imaging and the increasing number of radiopharmaceuticals have resulted in a surge of diagnostic nuclear medicine applications. Therapeutic applications are also gaining ground because of the possibility for systemic, targeted treatments. NCINM, the National Cancer Institute dosimetry system for Nuclear Medicine, has been developed to provide accurate dosimetry for patients undergoing nuclear medicine procedures.
Most of the current dosimetry tools for nuclear medicine procedures are based on simplified phantoms developed in 1990s or do not account for patient body size. NCINM incorporates state-of-the-art pediatric and adult computational human phantoms. NCINM also adopts the Specific Absorbed Fraction data for the International Commission on Radiological Protection (ICRP) reference adult male and female phantoms in the ICRP Publication 13330 and will be extended to the pediatric data once the ICRP data will be available. Implementation of additional non-human data including mice, canine, and primates is in progress.
COMPREHENSIVE DOSIMETRY DATABASE
NCINM includes a comprehensive library of dose conversion coefficients for various radionuclides, called S values, which convert cumulated activities into organ absorbed dose. The program covers up to 70 source regions and 60 target regions defined within the human anatomy. S values are available for a total of 300 clinically-relevant radionuclides for which energy spectra were obtained from the ICRP Publication 10731.
INTUITIVE USER INTERFACE
NCINM provides an intuitive graphical user interface allowing users to select from twelve pediatric and adult phantoms, enter the radionuclide and injected activity, and organ residence times (or cumulated activity). Data is available for 300 radionuclides, 70 source regions, and 55 target regions. NCINM rapidly calculates the organ dose and dose per administered activity. All input and output processes are conducted in a single window. NCINM runs on multiple platforms including Windows, Mac, and LINUX.
Because of the increasing use of diagnostic and interventional fluoroscopy techniques in recent years, there has been a concern regarding the radiogenic risk of cancer from the exposure source. It is important to accurately estimate organ doses to optimize the radiological procedures to provide the minimum dose and best image quality. To meet the needs, the National Cancer Institute dosimetry system for Radiography and Fluoroscopy, NCIRF, has been developed.
NCIRF features state-of-the-art pediatric and adult computational human phantoms developed by the University of Florida and National Cancer Institute, representing reference individuals defined by the International Commission on Radiological Protection (ICRP). The phantom library will be extended to include the ICRP reference phantoms, the body size-dependent phantom library, and pregnant women phantoms.
ON-THE-FLY MONTE CARLO CALCULATIONS
Interventional fluoroscopy often involves x-ray irradiation at various angles, even in a single session. Dose estimation based on pre-calculated dose tables may provide substantial dosimetric errors. Therefore, it is crucial to calculate organ dose using on-the-fly Monte Carlo radiation transport techniques. A 3D Monte Carlo, dose calculation module, based on an extensively benchmarked Monte Carlo code, GEANT4, is built in NCIRF and running in the background.
INTUITIVE USER INTERFACE
NCIRF provides an intuitive graphical user interface allowing users to select from various pediatric and adult computational phantoms and enter x-ray source definition, and finally to output organ doses with statistical errors. NCIRF is running on a personal computer, but users also can export input files running directly on a general-purpose Monte Carlo code, MCNP, to utilize their parallel computing servers. NCIRF also features a batch module where users can automatically run many radiation events.
We calculated dose coefficients for the International Commission on Radiological Protection (ICRP) reference pediatric phantoms externally exposed to mono-energetic photon radiation (x- and gamma-rays). Calculations were performed using Monte Carlo radiation transport techniques. Dose coefficients, i.e., organ absorbed dose per unit air kerma (mGy/mGy), were calculated for 28 organs and tissues including the active marrow (or red bone marrow) for 10 phantoms (newborn, 1-year, 5-year, 10-year, and 15-year old male and female). Radiation exposure was simulated for 33 photon mono-energies (0.01 – 20 MeV) in six irradiation geometries: Antero-Posterior (AP), Postero-Anterior (PA), Right-Lateral (RLAT), Left-Lateral (LLAT), Rotational (ROT), and Isotropic (ISO).
The International Commission on Radiological Protection (ICRP) Publication 116 includes adult male and female neutron fluence-to-dose coefficients for external exposures for the six idealized irradiation geometries (AP, PA, LLAT, RLAT, ROT, and ISO). These dose coefficients are not appropriate for children due to their smaller body weight and stature. We calculated neutron dose coefficients for pediatric phantoms (newborn, 1-, 5-, 10-, and 15-year-old) from the PHANTOMS library. Calculations were performed using the MCNP6 code for neutron energies between 0.001 eV and 10 GeV, including 28 organs, two bone tissues, and the overall whole-body effective dose.
- Lee C, Lodwick D, Hurtado J, Pafundi D, Williams JL, Bolch WE. The UF family of reference hybrid phantoms for computational radiation dosimetry. Phys Med Biol. 2010;55(2):339-363.
- Geyer AM, O’Reilly S, Lee C, Long DJ, Bolch WE. The UF/NCI family of hybrid computational phantoms representing the current US population of male and female children, adolescents, and adults--application to CT dosimetry. 2014;59(18):5225-5242.
- Lee C, Lamart S, Moroz BE. Computational lymphatic node models in pediatric and adult hybrid phantoms for radiation dosimetry. Phys Med Biol. 2013;58(5):N59--N82.
- Lee C, Kaufman K, Pafundi DH, Bolch WE. An Algorithm for Lymphatic Node Placement in Hybrid Computational Phantoms: Applications to Radionuclide Therapy Dosimetry. Proc IEEE. 2009;97(12):2098-2108. doi:10.1109/JPROC.2009.2025399.
- Villoing D, McMillan D, Kim KP, et al. Korean pediatric and adult head computational phantoms and application to photon specific absorbed fractions calculations. Radiat Prot Dosimetry. February 2017:1-8. doi:10.1093/rpd/ncx009.
- ICRP. Basic anatomical and physiological data for use in radiological protection : reference values. ICRP Publ 89 Ann ICRP. 2002;32(3-4):1-277.
- ICRU. Photon, Electron, Proton and Neutron Interaction Data for Body Tissues. Bethesda, MD: International Commission on Radiation Units and Measurements; 1992.
- ICRP. Human alimentary tract model for radiological protection. ICRP Publ 100 Ann ICRP. 2006;36(1-2):1-336. doi:10.1016/j.icrp.2006.03.004.
- Lee C, Kim KP, Bolch WE, Moroz BE, Les Folio. NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans. J Radiol Prot. 2015;35(4):891-909. doi:10.1088/0952-4746/35/4/891
- Long DJ, Lee C, Tien C, et al. Monte Carlo simulations of adult and pediatric computed tomography exams: Validation studies of organ doses with physical phantoms. Med Phys. 2013;40(1):13901. doi:10.1118/1.4771934
- Dabin J, Mencarelli A, McMillan D, Romanyukha A, Struelens L, Lee C. Validation of calculation algorithms for organ doses in CT by measurements on a 5 year old paediatric phantom. Phys Med Biol. 2016;61(11):4168-4182. doi:10.1088/0031-9155/61/11/4168
- Giansante L, Martins JC, Nersissian DY, et al. Organ doses evaluation for chest computed tomography procedures with TL dosimeters: Comparison with Monte Carlo simulations. J Appl Clin Med Phys. December 2018. doi:10.1002/acm2.12505
- Maynard MR, Maynard MR, Geyer JW, et al. The UF family of hybrid phantoms of the developing human fetus for computational radiation dosimetry. Phys Med Biol. 2011;56(15):4839-4879. doi:10.1088/0031-9155/56/15/014
- Pokora R, Krille L, Dreger S, et al. Computed Tomography in Germany. Dtsch Arzteblatt Int. 2016;113:1-9. doi:10.3238/arztebl.2016.0
- Olerud HM, Toft B, Flatabø S, Jahnen A, Lee C, Thierry-Chef I. Reconstruction of paediatric organ doses from axial CT scans performed in the 1990s – range of doses as input to uncertainty estimates. Eur Radiol. January 2016:1-8. doi:10.1007/s00330-015-4157-6
- Meulepas JM, Ronckers C e cile M, Smets AMJB, et al. Leukemia and brain tumors among children after radiation exposure from CT scans: design and methodological opportunities of the Dutch Pediatric CT Study. Eur J Epidemiol. 2014;29:293-301. doi:10.1007/s10654-014-9900-9
- de Basea MB, Pearce MS, Kesminiene A, et al. EPI-CT: design, challenges and epidemiological methods of an international study on cancer risk after paediatric and young adult CT. J Radiol Prot. 2015;35(3):611-628. doi:10.1088/0952-4746/35/3/611
- Thierry-Chef I, Dabin J e r e mie, Friberg E, et al. Assessing Organ Doses from Paediatric CT Scans: A Novel Approach for an Epidemiology Study (the EPI-CT Study). Int J Environ Res Public Health. 2013;10(2):717-728. doi:10.3390/ijerph10020717
- Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012;380(9840):499-505. doi:10.1016/S0140-6736(12)60815-0
- Berrington de González A, Journy N, Lee C, et al. No association between radiation dose from pediatric CT scans and risk of subsequent Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev. January 2017:cebp.1011.2016-15. doi:10.1158/1055-9965.EPI-16-1011
- Journy NMY, Lee C, Harbron RW, McHugh K, Pearce MS, de Gonza acute lez AB. Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990–2020. Br J Cancer. 2016;116(1):109-116. doi:10.1038/bjc.2016.351
- Journy NMY, Dreuil S, Boddaert N, et al. Individual radiation exposure from computed tomography: a survey of paediatric practice in French university hospitals, 2010–2013. Eur Radiol. August 2017:1-12. doi:10.1007/s00330-017-5001-y
- Romanyukha A, Les Folio, Lamart S, Simon SL, Lee C. Body size-specific effective dose conversion coefficients for CT scans. Radiat Prot Dosimetry. 2016;172(4):ncv511-437. doi:10.1093/rpd/ncv511
- Bahadori A, Miglioretti D, Kruger R, et al. Calculation of Organ Doses for a Large Number of Patients Undergoing CT Examinations. Am J Roentgenol. 2015;205(4):827-833. doi:10.2214/AJR.14.14135
- Lodwick DL, Cooper JN, Adler B, et al. How to identify high radiation burden from computed tomography: an example in obese children. J Surg Res. 2017;217(Supplement C):54-62.e3. doi:10.1016/j.jss.2017.04.031
- Cooper JN, Lodwick DL, Adler B, Lee C, Minneci PC, Deans KJ. Patient characteristics associated with differences in radiation exposure from pediatric abdomen-pelvis CT scans: a quantile regression analysis. Comput Biol Med. 2017;85(Supplement C):7-12. doi:10.1016/j.compbiomed.2017.04.003
- Krille L, Dreger S, Schindel R, et al. Risk of cancer incidence before the age of 15 years after exposure to ionising radiation from computed tomography: results from a German cohort study. Radiat Environ Biophys. 2015;54(1):1-12. doi:10.1007/s00411-014-0580-3
- Lee C, Flynn MJ, Judy PF, Cody DD, Bolch WE, Kruger RL. Body Size–Specific Organ and Effective Doses of Chest CT Screening Examinations of the National Lung Screening Trial. Am J Roentgenol. 2017;208(5):1082-1088. doi:10.2214/AJR.16.16979
- Chang LA, Miller DL, Lee C, et al. Thyroid Radiation Dose to Patients from Diagnostic Radiology Procedures over Eight Decades: 1930–2010. Health Phys. 2017;113(6):458–473. doi:10.1097/HP.0000000000000723
- ICRP. The ICRP Computational Framework for Internal Dose Assessment for Reference Adults: Specific Absorbed Fractions. ICRP Publ 133 Ann ICRP. 2016;45(2):1-74.
- ICRP. Nuclear Decay Data for Dosimetric Calculations. ICRP Publ 107 Ann ICRP. 2008;38(3).
- Chang LA, Simon SL, Jorgensen TJ, Schauer DA, Lee C. Dose coefficients for ICRP reference pediatric phantoms exposed to idealised external gamma fields. J Radiol Prot. 2017;37(1):127-146. doi:10.1088/1361-6498/aa559e
- Griffin K, Mille M, Lee C. Dose coefficients for children and young adolescents exposed to external neutron fields. J Radiol Prot Off J Soc Radiol Prot. 2018;38(2):587-606. doi:10.1088/1361-6498/aab126
Anyone who is interested in receiving the resources on this website for research can:
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