Validation study of the thorax phantom Lungman for optimization purposes

This work aims to investigate the advantages and limitations of the Kyoto Kagaku thorax phantom Lungman for use in chest radiography optimization studies. First, patient survey data were gathered for chest posterior anterior (PA) and lateral (LAT) examinations in a standard chest X-ray room over a period of one year, using a Caesium Iodide (CsI) based flat panel detector with automatic exposure control (AEC). Parameters surveyed included exposure index (EI), dose area product (DAP) and AEC exposure time. PA and LAT projections of the phantom were then compared to these values. Additionally, the equivalence in millimetres of poly (methyl methacrylate) (PMMA) was established for the different regions of the Lungman phantom (lungs and mediastinum). Finally, a voxel model of the Lungman phantom was developed by the segmentation of a volumetric dataset of the phantom acquired using CT scanning. Subsequently, the model was used in Monte Carlo simulations with PENELOPE/penEasy code to calculate the energy deposited in the organs of the phantom. This enabled comparison of the phantom tissue-equivalent materials with materials defined by ICRP 89 in terms of energy deposition. For the survey data, close agreement was found between phantom and the median values for the patient data (deviations ranged from 4% to 31%, one outlier). The phantom lung region is equivalent to 89 mm to 106 mm of PMMA, depending on tube voltage. Energy deposited in the phantom material compared to those for ICRP defined material differed by at most 36% in AP irradiations and 49% in PA irradiations.