Simulation of the upper gastrointestinal fluoroscopic examination for calculation of absorbed dose in tissue

In order to simulate the upper gastrointestinal fluoroscopic examination, modifications were made to the Monte Carlo radiation-transport code that uses the anthropomorphic, mathematical reference phantoms ADAM and EVA. A set of discrete x-ray field projections of the principal anatomy of clinical interest has been previously defined. This note describes the new features incorporated in the simulations--divergent beams in oblique irradiation geometries, an esophagus and a duodenum, a double contrast medium consisting of a BaSO4-H2O mixture and air in the esophagus, stomach, and duodenum, and clinically representative beam qualities. The absorbed doses in tissues per unit entrance exposure (free-in-air) computed with the modified code appeared in Department of Health and Human Services Publication FDA 92-8282, Handbook of Selected Tissue Doses for the Upper Gastrointestinal Fluoroscopic Examination. A minor correction is described for the previously reported results for the esophagus.