On the need to revise the arm structure in stylized anthropomorphic phantoms in lateral photon irradiation geometry

Distributions of radiation absorbed dose within human anatomy have been estimated through Monte Carlo radiation transport techniques implemented for two different classes of computational anthropomorphic phantoms: (1) mathematical equation-based stylized phantoms and (2) tomographic image-based voxel phantoms. Voxel phantoms constructed from tomographic images of real human anatomy have been actively developed since the late 1980s to overcome the anatomical approximations necessary with stylized phantoms, which themselves have been utilized since the mid 1960s. However, revisions of stylized phantoms have also been pursued in parallel to the development of voxel phantoms since voxel phantoms (1) are initially restricted to the individual-specific anatomy of the person originally imaged, (2) must be restructured on an organ-by-organ basis to conform to reference individual anatomy and (3) cannot easily represent very fine anatomical structures and tissue layers that are thinner than the voxel dimensions of the overall phantom. Although efforts have been made to improve the anatomic realism of stylized phantoms, most of these efforts have been limited to attempts to alter internal organ structures. Aside from the internal organs, the exterior shapes, and especially the arm structures, of stylized phantoms are also far from realistic descriptions of human anatomy, and may cause dosimetry errors in the calculation of organ-absorbed doses for external irradiation scenarios. The present study was intended to highlight the need to revise the existing arm structure within stylized phantoms by comparing organ doses of stylized adult phantoms with those from three adult voxel phantoms in the lateral photon irradiation geometry. The representative stylized phantom, the adult phantom of the Oak Ridge National Laboratory (ORNL) series and two adult male voxel phantoms, KTMAN-2 and VOXTISS8, were employed for Monte Carlo dose calculation, and data from another voxel phantom, VIP-Man, were obtained from literature sources. The absorbed doses for lungs, oesophagus, liver and kidneys that could be affected by arm structures in the lateral irradiation geometry were obtained for both classes of phantoms in lateral monoenergetic photon irradiation geometries. As expected, those organs in the ORNL phantoms received apparently higher absorbed doses than those in the voxel phantoms. The overestimation is mainly attributed to the relatively poor representation of the arm structure in the ORNL phantom in which the arm bones are embedded within the regions describing the phantom's torso. The results of this study suggest that the overestimation of organ doses, due to unrealistic arm representation, should be taken into account when stylized phantoms are employed for equivalent or effective dose estimates, especially in the case of an irradiation scenario with dominating lateral exposure. For such a reason, the stylized phantom arm structure definition should be revised in order to obtain more realistic evaluations.