Spring Land Temperature in Tibetan Plateau Enhances Global-Scale Summer Precipitation Prediction
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54 ENVIRONMENTAL SCIENCES↗
Engineering topics
Qi, X
Publications and source records attributed to Qi, X.
SU-F-J-17: Patient Localization Using MRI-Guided Soft Tissue for Head-And-Neck Radiotherapy: Indication for Margin Reduction and Its Feasibility
Purpose: On-board MRI provides superior soft-tissue contrast, allowing patient alignment using tumor or nearby critical structures. This study aims to study H&N MRI-guided IGRT to analyze inter-fraction patient setup variations using soft-tissue targets and design appropriate CTV-to-PTV margin and clinical implication. Methods: 282 MR images for 10 H&N IMRT patients treated on a ViewRay system were retrospectively analyzed. Patients were immobilized using a thermoplastic mask on a customized headrest fitted in a radiofrequency coil and positioned to soft-tissue targets. The inter-fraction patient displacements were recorded to compute the PTV margins using the recipe: 2.5∑+0.7σ. New IMRT plans optimized on the revised PTVs were generated to evaluate the delivered dose distributions. An in-house dose deformation registration tool was used to assess the resulting dosimetric consequences when margin adaption is performed based on weekly MR images. The cumulative doses were compared to the reduced margin plans for targets and critical structures. Results: The inter-fraction displacements (and standard deviations), ∑ and σ were tabulated for MRI and compared to kVCBCT. The computed CTV-to-PTV margin was 3.5mm for soft-tissue based registration. There were minimal differences between the planned and delivered doses when comparing clinical and the PTV reduced margin plans: the paired t-tests yielded p=0.38 and 0.66 between the planned and delivered doses for the adapted margin plans for the maximum cord and mean parotid dose, respectively. Target V95 received comparable doses as planned for the reduced margin plans. Conclusion: The 0.35T MRI offers acceptable soft-tissue contrast and good spatial resolution for patient alignment and target visualization. Better tumor conspicuity from MRI allows soft-tissue based alignments with potentially improved accuracy, suggesting a benefit of margin reduction for H&N radiotherapy. The reduced margin plans (i.e., 2 mm) resulted in improved normal structure sparing and accurate dose delivery to achieve intended treatment goal under MR guidance.
60 APPLIED LIFE SCIENCES↗
SU-F-J-135: Tumor Displacement-Based Binning for Respiratory-Gated Time-Independent 5DCT Treatment Planning
Purpose: A published 5DCT breathing motion model enables image reconstruction at any user-selected breathing phase, defined by the model as a specific amplitude (v) and rate (f). Generation of reconstructed phase-specific CT scans will be required for time-independent radiation dose distribution simulations. This work answers the question: how many amplitude and rate bins are required to describe the tumor motion with a specific spatial resolution? Methods: 19 lung-cancer patients with 21 tumors were scanned using a free-breathing 5DCT protocol, employing an abdominally positioned pneumatic-bellows breathing surrogate and yielding voxel-specific motion model parameters α and β corresponding to motion as a function of amplitude and rate, respectively. Tumor GTVs were contoured on the first (reference) of 25 successive free-breathing fast helical CT image sets. The tumor displacements were binned into widths of 1mm to 5mm in 1mm steps and the total required number of bins recorded. The simulation evaluated the number of bins needed to encompass 100% of the breathing-amplitude and between the 5th and 95th percentile amplitudes to exclude breathing outliers. Results: The mean respiration-induced tumor motion was 9.90mm ± 7.86mm with a maximum of 25mm. The number of bins required was a strong function of the spatial resolution and varied widely between patients. For example, for 2mm bins, between 1–13 amplitude bins and 1–9 rate bins were required to encompass 100% of the breathing amplitude, while 1–6 amplitude bins and 1–3 rate bins were required to encompass 90% of the breathing amplitude. Conclusion: The strong relationship between number of bins and spatial resolution as well as the large variation between patients implies that time-independent radiation dose distribution simulations should be conducted using patient-specific data and that the breathing conditions will have to be carefully considered. This work will lead to the assessment of the dosimetric impact of binning resolution. This study is supported by Siemens Healthcare.
60 APPLIED LIFE SCIENCES↗
SU-F-J-181: An Alternative Patient Alignment Tool On TomoTherapy: The First In- Human Megavoltage-Topogram Acquisition
Purpose: To show the first in-human Megavoltage (MV)-Topogram acquisition for the evaluation of the potential for MV-Topogram-based alignment as an alternative to MVCT for reducing dose and imaging time. Methods: A lung cancer patient was enrolled in an ongoing IRB-approved clinical trial at our institute. The patient was set up using the clinical protocol employing positioning lasers. 3.2mm diameter tungsten spheres were placed on the patient’s skin at their alignment tattoos to check surface-based marker concordance between topograms and MVCT. Anterior-Posterior (AP) and lateral (LAT) MV-Topograms were acquired using gantry angles of 0°/90° with a 1mm collimator opening, all MLC leafs open, 4cm/s couch speed, and 12.5s scanning time. The topogram acquisition was immediately followed by the normal MVCT scan acquisition. MV-Topograms were reconstructed from the detector exit-data using in-house developed software. The topograms were also enhanced using contrast-limited adaptive histogram equalization (CLAHE). The MV-Topograms were registered to reference kV-based digitally reconstructed topograms. The localization results were compared against results obtained comparing the clinical MVCT to the kVCT simulation. Results: The shifts using the unenhanced Topograms, enhanced Topograms, and MVCT were (LAT, LONG, VERT, ROLL) (5.8mm, 2.6mm, −5.6mm, 0.34°), (3.9mm, 2.5mm, −2.2mm, 0.65°) and (2.4mm, 1.5mm, −3.0mm, 0.5°), respectively. The magnitude alignment differences between the enhanced Topograms and MVCT were within 1.5 mm and 0.15°. The average MVCT and total Topogram acquisition times were 272.9s ± 31.5s and 46s, respectively. Conclusion: MV-Topograms have the potential for providing equivalent performance with less dose and acquisition time than the traditional MVCT technique. We are evaluating other sites as well as adding patients to develop statistically significant analyses regarding the alignment quality differences. MV-Topograms are likely to be most clinically useful for bony anatomy and radiopaque marker-based alignments. The study was supported by an Accuray Grant.
60 APPLIED LIFE SCIENCES↗
SU-F-T-435: Helical Tomotherapy for Craniospinal Irradiation: What We Have Learned from a Multi-Institutional Study
Purpose: To report cranio-spinal irradiation (CSI) planning experience, compare dosimetric quality and delivery efficiency with Tomotherapy from different institutions, and to investigate effect of planning parameters on plan quality and treatment time. Methods: Clinical helical tomotherapy IMRT plans for thirty-nine CSI cases from three academic institutions were retrospectively evaluated. The planning parameters: field width (FW), pitch, modulation factor (MF), and achieved dosimetric endpoints were cross-compared. A fraction-dose-delivery-timing index (FDTI), defined as treatment time per fraction dose per PTV length, was utilized to evaluate plan delivery efficiency. A lower FDTI indicates higher delivery efficiency. We studied the correlation between planning quality, treatment time and planning parameters by grouping the plans under specific planning parameters. Additionally, we created new plans using 5cm jaw for a subset of plans that used 2.5cm jaw to exam if treatment efficiency can be improved without sacrificing plan quality. Results: There were significant dosimetric differences for organ at risks (OARs) among different institutions (A,B,C). Using the lowest average MF (1.9±0.4) and 5cm field width, C had the highest lung, heart, kidney, liver mean doses and maximum doses for lens. Using the same field width of 5cm, but higher MF (2.6±0.6), B had lower doses to the OARs in the thorax and abdomen area. Most of A’s plans were planned with 2.5cm jaw, the plans yielded better PTV coverage, higher OAR doses and slightly shorter FDTI compared to institution B. The replanned 5cm jaw plans achieved comparable PTV coverage and OARs sparing, while saving up to 44.7% treatment time. Conclusion: Plan quality and delivery efficiency could vary significantly in CSI planning on Tomotheapy due to choice of different planning parameters. CSI plans using a 5cm jaw, with proper selection of pitch and MF, can achieve comparable/ better plan quality with shorter delivery time compared to 2.5cm jaw plans.
60 APPLIED LIFE SCIENCES↗
WE-FG-202-08: Assessment of Treatment Response Via Longitudinal Diffusion MRI On A MRI-Guided System: Initial Experience of Quantitative Analysis
Purpose: To report our initial experience of systematic monitoring treatment response using longitudinal diffusion MR images on a Co-60 MRI-guided radiotherapy system. Methods: Four patients, including 2 head-and-necks, 1 sarcoma and 1 GBM treated on a 0.35 Tesla MRI-guided treatment system, were analyzed. For each patient, 3D TrueFISP MRIs were acquired during CT simulation and before each treatment for treatment planning and patient setup purposes respectively. Additionally, 2D diffusion-weighted MR images (DWI) were acquired weekly throughout the treatment course. The gross target volume (GTV) and brainstem (as a reference structure) were delineated on weekly 3D TrueFISP MRIs to monitor anatomy changes, the contours were then transferred onto the corresponding DWI images after fusing with the weekly TrueFISP images. The patient-specific temporal and spatial variations during the entire treatment course, such as anatomic changes, target apparent diffusion coefficient (ADC) distribution were evaluated in a longitudinal pattern. Results: Routine MRI revealed progressive soft-tissue GTV volume changes (up to 53%) for the H&N cases during the treatment course of 5–7 weeks. Within the GTV, the mean ADC values varied from −44% (ADC decrease) to +26% (ADC increase) in a week. The gradual increase of ADC value was inversely associated with target volume variation for one H&N case. The maximal changes of mean ADC values within the brainstem were 5.3% for the H&N cases. For the large size sarcoma and GBM tumors, spatial heterogeneity and temporal variations were observed through longitudinal ADC analysis. Conclusion: In addition to the superior soft-tissue visualization, the 0.35T MR system on ViewRay showed the potential to quantitatively measure the ADC values for both tumor and normal tissues. For normal tissue that is minimally affected by radiation, its ADC values are reproducible. Tumor ADC values show temporal and spatial fluctuation that can be exploited for personalized adaptive therapy.
60 APPLIED LIFE SCIENCES↗
A framework for benchmarking land models
Land models, which have been developed by the modeling community in the past few decades to predict future states of ecosystems and climate, have to be critically evaluated for their performance skills of simulating ecosystem responses and feedback to climate change. Benchmarking is an emerging procedure to measure performance of models against a set of defined standards. This paper proposes a benchmarking framework for evaluation of land model performances and, meanwhile, highlights major challenges at this infant stage of benchmark analysis. The framework includes (1) targeted aspects of model performance to be evaluated, (2) a set of benchmarks as defined references to test model performance, (3) metrics to measure and compare performance skills among models so as to identify model strengths and deficiencies, and (4) model improvement. Land models are required to simulate exchange of water, energy, carbon and sometimes other trace gases between the atmosphere and land surface, and should be evaluated for their simulations of biophysical processes, biogeochemical cycles, and vegetation dynamics in response to climate change across broad temporal and spatial scales. Thus, one major challenge is to select and define a limited number of benchmarks to effectively evaluate land model performance. The second challenge is to develop metrics of measuring mismatches between models and benchmarks. The metrics may include (1) a priori thresholds of acceptable model performance and (2) a scoring system to combine data–model mismatches for various processes at different temporal and spatial scales. The benchmark analyses should identify clues of weak model performance to guide future development, thus enabling improved predictions of future states of ecosystems and climate. The near-future research effort should be on development of a set of widely acceptable benchmarks that can be used to objectively, effectively, and reliably evaluate fundamental properties of land models to improve their prediction performance skills.
Biophysical Processes↗