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Wang, J

Publications and source records attributed to Wang, J.

At least 55 records · Page 3

SU-F-T-251: The Quality Assurance for the Heavy Patient Load Department in the Developing Country: The Primary Experience of An Entire Workflow QA Process Management in Radiotherapy

Purpose: To implement an entire workflow quality assurance (QA) process in the radiotherapy department and to reduce the error rates of radiotherapy based on the entire workflow management in the developing country. Methods: The entire workflow QA process management starts from patient registration to the end of last treatment including all steps through the entire radiotherapy process. Error rate of chartcheck is used to evaluate the the entire workflow QA process. Two to three qualified senior medical physicists checked the documents before the first treatment fraction of every patient. Random check of the treatment history during treatment was also performed. A total of around 6000 patients treatment data before and after implementing the entire workflow QA process were compared from May, 2014 to December, 2015. Results: A systemic checklist was established. It mainly includes patient’s registration, treatment plan QA, information exporting to OIS(Oncology Information System), documents of treatment QAand QA of the treatment history. The error rate derived from the chart check decreases from 1.7% to 0.9% after our the entire workflow QA process. All checked errors before the first treatment fraction were corrected as soon as oncologist re-confirmed them and reinforce staff training was accordingly followed to prevent those errors. Conclusion: The entire workflow QA process improved the safety, quality of radiotherapy in our department and we consider that our QA experience can be applicable for the heavily-loaded radiotherapy departments in developing country.

60 APPLIED LIFE SCIENCES↗

SU-F-T-336: A Quick Auto-Planning (QAP) Method for Patient Intensity Modulated Radiotherapy (IMRT)

Purpose: The aim of this study is to develop a quick auto-planning system that permits fast patient IMRT planning with conformal dose to the target without manual field alignment and time-consuming dose distribution optimization. Methods: The planning target volume (PTV) of the source and the target patient were projected to the iso-center plane in certain beameye- view directions to derive the 2D projected shapes. Assuming the target interior was isotropic for each beam direction boundary analysis under polar coordinate was performed to map the source shape boundary to the target shape boundary to derive the source-to-target shape mapping function. The derived shape mapping function was used to morph the source beam aperture to the target beam aperture over all segments in each beam direction. The target beam weights were re-calculated to deliver the same dose to the reference point (iso-center) as the source beam did in the source plan. The approach was tested on two rectum patients (one source patient and one target patient). Results: The IMRT planning time by QAP was 5 seconds on a laptop computer. The dose volume histograms and the dose distribution showed the target patient had the similar PTV dose coverage and OAR dose sparing with the source patient. Conclusion: The QAP system can instantly and automatically finish the IMRT planning without dose optimization.

60 APPLIED LIFE SCIENCES↗

SU-F-T-355: Evaluation of Knowledge-Based Planning Model for the Cervical Cancer Radiotherapy

Purpose: The Varian RapidPlan™ is a commercial knowledge-based optimization process which uses a set of clinically used treatment plans to train a model that can predict individualized dose-volume objectives. The purpose of this study is to evaluate the performance of RapidPlan to generate intensity modulated radiation therapy (IMRT) plans for cervical cancer. Methods: Totally 70 IMRT plans for cervical cancer with varying clinical and physiological indications were enrolled in this study. These patients were all previously treated in our institution. There were two prescription levels usually used in our institution: 45Gy/25 fractions and 50.4Gy/28 fractions. 50 of these plans were selected to train the RapidPlan model for predicting dose-volume constraints. After model training, this model was validated with 10 plans from training pool(internal validation) and additional other 20 new plans(external validation). All plans used for the validation were re-optimized with the original beam configuration and the generated priorities from RapidPlan were manually adjusted to ensure that re-optimized DVH located in the range of the model prediction. DVH quantitative analysis was performed to compare the RapidPlan generated and the original manual optimized plans. Results: For all the validation cases, RapidPlan based plans (RapidPlan) showed similar or superior results compared to the manual optimized ones. RapidPlan increased the result of D98% and homogeneity in both two validations. For organs at risk, the RapidPlan decreased mean doses of bladder by 1.25Gy/1.13Gy (internal/external validation) on average, with p=0.12/p<0.01. The mean dose of rectum and bowel were also decreased by an average of 2.64Gy/0.83Gy and 0.66Gy/1.05Gy,with p<0.01/ p<0.01and p=0.04/<0.01 for the internal/external validation, respectively. Conclusion: The RapidPlan model based cervical cancer plans shows ability to systematically improve the IMRT plan quality. It suggests that RapidPlan has great potential to make the treatment planning process more efficient.

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SU-F-T-358: Is Auto-Planning Useful for Volumetric-Modulated Arc Therapy Planning in Rectal Cancer Radiotherapy?

Purpose: To evaluate whether Auto-Planning based volumetric-modulated radiotherapy (auto-VMAT) can reduce manual interaction time during treatment planning and improve plan quality for rectal cancer radiotherapy. Methods: Ten rectal cancer patients (stage II and III) after radical resection using Dixon surgery were enrolled. All patients were treated with VMAT technique. The manual VMAT plans (man-VMAT) were designed in the Pinnacle treatment planning system (Version 9.10) following the standard treatment planning procedure developed in our department. Clinical plans were manually designed by our experienced dosimetrists. Additionally, an auto-VMAT plan was created for each patient using Auto-Planning module. However, manual interaction was still applied to meet the clinical requirements. The treatment planning time and plan quality surrogated by the DVH parameters were compared between manual and automated plans. Results: The total planning time and manual interaction time were 50.38 and 4.47 min for the auto-VMAT and 36.81 and 16.94 min for the man-VMAT (t=60.14,−23.86; p=0.000, 0.000). In terms of plan quality, both plans meet the clinical requirements. The PTV homogeneity index (HI) and conformity index (CI) were 0.054 and 0.822 for the auto-VMAT and 0.059 and 0.815 for the man-VMAT (t=−1.72, 0.36;p=0.119,0.730).Compared to the man-VMAT, the auto-VMAT showed reduction of 11.9% and 0.7% in V40 and V50 of the bladder, respectively.The V30 and D mean were reduced by 14.0% and 5.1Gy in the left femur and 12.2% and 3.8Gy in the right femur. Conclusion: The Auto-Planning based VMAT plans not only shows similar or superior plan quality to the manual ones in the rectal cancer radiotherapy, but also improve the planning efficiency significantly. However, manual interactions are still required to achieve a clinically acceptable plan based on our experiences.

60 APPLIED LIFE SCIENCES↗

SU-F-T-359: Incorporating Dose Volume Histogram Prediction Into Auto-Planning for Volumetric-Modulated Arc Therapy in Rectal Cancer

Purpose: To incorporate dose volume histogram (DVH) prediction into Auto-Planning for volumetric-modulated arc therapy (VMAT) treatment planning and investigate the benefit of this new technique for rectal cancer. Methods: Ninety clinically accepted VMAT plans for patients with rectal cancer were selected and trained in the RapidPlan for DVH prediction. Both internal and external validations were performed before implementing the prediction model. A new VMAT planning method (hybrid-VMAT) was created with combining the DVH prediction and Auto-Planning. For each new patient, the DVH will be predicted and individual DVH constrains will be obtained and were exported as the original optimization parameters to the Auto-Planning (Pinnacle3 treatment planning system, v9.10) for planning. A total of 20 rectal cancer patients previously treated with manual VMAT (manual-VMAT) plans were replanned using this new method. Dosimetric comparisons were performed between manual VMAT and new method plans. Results: Hybrid-VMAT shows similar PTV coverage to manual-VMAT in D2%, D98% and HI (p>0.05) and superior coverage in CI (p=0.000). For the bladder, the means of V40 and mean dose are 36.0% and 35.6Gy for hybrid-VMAT and 42% and 38.0Gy for the manual-VMAT. For the left (right) femur, the means of V30 and mean dose are 10.6% (11.6%) and 17.9Gy (19.2Gy) for the hybrid-VMAT and 25.6% (24.1%) and 27.3Gy (26.2Gy) for the manual-VMAT. The hybrid-VMAT has significantly improved the organs at risk sparing. Conclusion: The integration of DVH prediction and Auto-Planning significantly improve the VMAT plan quality in the rectal cancer radiotherapy. Our results show the benefit of the new method and will be further investigated in other tumor sites.

60 APPLIED LIFE SCIENCES↗

SU-F-T-447: The Impact of Treatment Planning Methods On RapidPlan Modeling for Rectum Cancer

Purpose: To investigate the dose volume histogram (DVH) prediction varieties based on intensity modulate radiotherapy (IMRT) plan or volume arc modulate radiotherapy (VMAT) plan models on the RapidPlan. Methods: Two DVH prediction models were generated in this study, including an IMRT model trained from 83 IMRT rectum plans and a VMAT model trained from 60 VMAT rectum plans. In the internal validation, 20 plans from each training database were selected to verify the clinical feasibility of the model. Then, 10 IMRT plans (PIMRT-by-IMRT-model) generated from IMRT model and 10 IMRT plans generated from VMAT model (PIMRT-by-VMAT-model) were compared on the dose to organs at risk (OAR), which included bladder, left and right femoral heads. The similar comparison was also performed on the VMAT plans generated from IMRT model (PVMAT-by-IMRT-model) and VMAT plans generated from VMAT (PVMAT-by-VMAT-model) model. Results: For the internal validation, all plans from IMRT or VMAT model shows significantly improvement on OAR sparing compared with the corresponded clinical ones. Compared to the PIMRT-by-VMAT-model, the PIMRT-by-IMRT-model has a reduction of 6.90±3.87%(p<0.001) on V40 6.63±3.62%(p<0.001) on V45 and 4.74±2.26%(p<0.001) on V50 in bladder; and a mean dose reduction of 2.12±1.75Gy(p=0.004) and 2.84±1.53Gy(p<0.001) in right and left femoral head, respectively. There was no significant difference on OAR sparing between PVMAT-by-IMRT-model and PVMAT-by-VMAT-model. Conclusion: The IMRT model for the rectal cancer in the RapidPlan can be applied to for VMAT planning. However, the VMAT model is not suggested to use in the IMRT planning. Cautions should be taken that the planning model based on some technique may not feasible to other planning techniques.

60 APPLIED LIFE SCIENCES↗

SU-F-T-450: The Investigation of Radiotherapy Quality Assurance and Automatic Treatment Planning Based On the Kernel Density Estimation Method

Purpose: To develop a fast automatic algorithm based on the two dimensional kernel density estimation (2D KDE) to predict the dose-volume histogram (DVH) which can be employed for the investigation of radiotherapy quality assurance and automatic treatment planning. Methods: We propose a machine learning method that uses previous treatment plans to predict the DVH. The key to the approach is the framing of DVH in a probabilistic setting. The training consists of estimating, from the patients in the training set, the joint probability distribution of the dose and the predictive features. The joint distribution provides an estimation of the conditional probability of the dose given the values of the predictive features. For the new patient, the prediction consists of estimating the distribution of the predictive features and marginalizing the conditional probability from the training over this. Integrating the resulting probability distribution for the dose yields an estimation of the DVH. The 2D KDE is implemented to predict the joint probability distribution of the training set and the distribution of the predictive features for the new patient. Two variables, including the signed minimal distance from each OAR (organs at risk) voxel to the target boundary and its opening angle with respect to the origin of voxel coordinate, are considered as the predictive features to represent the OAR-target spatial relationship. The feasibility of our method has been demonstrated with the rectum, breast and head-and-neck cancer cases by comparing the predicted DVHs with the planned ones. Results: The consistent result has been found between these two DVHs for each cancer and the average of relative point-wise differences is about 5% within the clinical acceptable extent. Conclusion: According to the result of this study, our method can be used to predict the clinical acceptable DVH and has ability to evaluate the quality and consistency of the treatment planning.

60 APPLIED LIFE SCIENCES↗

SU-G-BRB-08: Investigation On the Magnetic Field Effect On TLDs, OSLDs, and Gafchromic Films Using An MR-Linac

Purpose: To investigate whether a strong magnetic field (B=1.5 T) can affect dose responses of thermoluminescent dosimeters (TLDs), optically stimulated luminescence dosimeters (OSLDs) and Gafchromic films using an MR-Linac (Elekta) before and after the magnet was ramped down from 1.5 T to 0 T. Methods: Three types of dosimeters (TLDs, OSLDs, EBT3 films) were divided into two groups. Group 1 was first irradiated in a phantom of Solid Water slabs (Standard Imaging) inside a B=1.5 T field with a 7 MV beam from an MR-Linac system. The radiation output at the location of the dosimeters (isocenter at 10 cm depth) was measured using an ion chamber (NE2571, Phoenix Dosimetry). Three doses (150, 300, 600 MU, corresponding to 1.18, 2.36, and 4.74 Gy) were delivered to the dosimeters. A week later the MR magnet was ramped down to zero field and dosimeters in Group 2 were irradiated with the same MUs. Dosimeters of each type were read out during the same session (about 4 weeks post irradiation in the B field, and 3 weeks with no B field). The ratios of signals between Group 1 and Group 2 were calculated. Results: Radiation output measured with the chamber was within 1% before and after ramping down the MR magnet. For TLDs, the ratio of signals with B field to signals without B field averaged over three dose levels was 1.003±0.016; for OSLDs, the ratio was 0.994±0.022; for films, the ratios of two batches (different manufacturing dates) were 0.997 and 0.985. Conclusion: Dose responses of all three dosimeters seem not affected by the presence of a 1.5 T magnetic field within uncertainty of ∼2%. More measurements will be conducted to test reproducibility. We acknowledge research support from Elekta AB.

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SU-G-TeP1-07: Investigation of RapidPlan Based Plan Quality for Breast IMRTSimultaneously Integrated Boost

Purpose: The aim of this study is to investigate the feasibility of using RapidPlan for breast cancer radiotherapy and to evaluate its performance for planners with different planning experiences. Methods: A training database was collected with 80 expert plan datasets from patients previously received left breast conserving surgery and IMRT-simultaneously integrated boost radiotherapy. The models were created on the RapidPlan. Five patients from the training database and 5 external patients were used for internal and external validation, respectively. Three planners with different planning experiences (beginner, junior, senior) designed manual and RapidPlan based plans for additional ten patients. The plan qualities were compared with manual and RapidPlan based ones. Results: For the internal and external validations, there were no significant dose differences on target coverage for plans from RapidPlan and manual. Also, no difference was found in the mean doses to contralateral breast and lung. The RapidPlan improved the heart (V5, V10, V20, V30, and mead dose) and ipsilateral lung (V5, V10, V20, V30, and mean dose) sparing for the beginner and junior planners. Compare to the plans from senior planner, 6 out of 16 clinically checked parameters were improved in RapidPlan, and the left parameters were similar. Conclusion: It is feasible to generate clinical acceptable plans using RapidPlan for breast cancer radiotherapy. The RapidPlan helps to systematically improve the quality of IMRT plans against the benchmark of clinically accepted plans. The RapidPlan shows promise for homogenizing plan quality by transferring planning expertise from more experienced to less experienced planners.

60 APPLIED LIFE SCIENCES↗

SU-G-IeP2-13: Toward Heavy Ion Computed Tomography with Carbon Ions: A Monte Carlo Study

Purpose: In the present Monte Carlo study, we investigated the use of Carbon ions for computed tomography (CT) with a relatively low imaging dose. This will enable us to avoid any conversion of X-ray CT numbers to the relative stopping power (or relative electron density) values and the associated uncertainties in Carbon dose calculation. Methods: In the first stage, we studied the propagation of Carbon nuclei through a water phantom using the Geant4 specially to understand their lateral displacement inside the phantom. In the second stage, we used our GPU-based Monte Carlo code, which has been cross validated against Geant4, to create the 2D map of the water equivalent path length (WEPL) inside a human head size phantom by acquiring 240 projections each 1.5° apart. Subsequently the 3D relative electron density map of the phantom was reconstructed from the 2D WEPL map using the Algebraic Reconstruction Technique (ART) coupled with total variation (TV) minimization Results: A high quality image of the relative electron density inside the phantom was reconstructed by ARTTV. The mean relative error between the reconstructed image for low contrast object (PMMA) was about 1.74%. The delivered dose per scan at the center of the phantom was about 0.1 Gy. Conclusion: We have been able to obtain a 3D map of the electron density using a human head size phantom while keeping the delivered dose to relatively low value. Using the GPU capabilities of our simulation engine, we believe that a real time CT with Carbon ions could be a reality in future.

60 APPLIED LIFE SCIENCES↗

SU-G-JeP2-04: Comparison Between Fricke-Type 3D Radiochromic Dosimeters for Real-Time Dose Distribution Measurements in MR-Guided Radiation Therapy

Purpose: To assess MR signal contrast for different ferrous ion compounds used in Fricke-type gel dosimeters for real-time dose measurements for MR-guided radiation therapy applications. Methods: Fricke-type gel dosimeters were prepared in 4% w/w gelatin prior to irradiation in an integrated 1.5 T MRI and 7 MV linear accelerator system (MR-Linac). 4 different ferrous ion (Fe2?) compounds (referred to as A, B, C, and D) were investigated for this study. Dosimeter D consisted of ferrous ammonium sulfate (FAS), which is conventionally used for Fricke dosimeters. Approximately half of each cylindrical dosimeter (45 mm diameter, 80 mm length) was irradiated to ∼17 Gy. MR imaging during irradiation was performed with the MR-Linac using a balanced-FFE sequence of TR/TE = 5/2.4 ms. An approximate uncertainty of 5% in our dose delivery was anticipated since the MR-Linac had not yet been fully commissioned. Results: The signal intensities (SI) increased between the un-irradiated and irradiated regions by approximately 8.6%, 4.4%, 3.2%, and 4.3% after delivery of ∼2.8 Gy for dosimeters A, B, C, and D, respectively. After delivery of ∼17 Gy, the SI had increased by 24.4%, 21.0%, 3.1%, and 22.2% compared to the un-irradiated regions. The increase in SI with respect to dose was linear for dosimeters A, B, and D with slopes of 0.0164, 0.0251, and 0.0236 Gy{sup −1} (R{sup 2} = 0.92, 0.97, and 0.96), respectively. Visually, dosimeter A had the greatest optical contrast from yellow to purple in the irradiated region. Conclusion: This study demonstrated the feasibility of using Fricke-type dosimeters for real-time dose measurements with the greatest optical and MR contrast for dosimeter A. We also demonstrated the need to investigate Fe{sup 2+} compounds beyond the conventionally utilized FAS compound in order to improve the MR signal contrast in 3D dosimeters used for MR-guided radiation therapy. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. LH- 102SPS.

60 APPLIED LIFE SCIENCES↗

SU-G-JeP2-11: Polymer Gels as 3D QA Devices in Magnetic Resonance-Guided Radiation Therapy

Purpose: To demonstrate the potential of polymer gels to serve as 3D QA devices in MR-guided radiotherapy. Methods: Custom-designed polymer gel dosimeters (MGS Research, Madison, CT) were centered on the penumbras of a radiation field, parallel to the magnetic field lines inside a 1.5 T MR scanner integrated with a 7 MV linac (MR-Linac). 15 Gy were delivered perpendicular to the magnetic field. Coronal MR images were acquired with a 2D balanced-Fast Field Echo (b-FFE) sequence in real-time during irradiation and with a 2D spin echo sequence at different times after irradiation. Signal intensities (SI) were measured inside and outside the radiation field on b-FFE images obtained during irradiation. Spin-spin relaxation rate (R2) maps were calculated from images after irradiation and penumbra widths were calculated from these maps. Results: A difference in SI between areas of the dosimeter inside and outside of the radiation field could be measured immediately after the beam was turned on. The difference in SI increased throughout the duration of the exposure. R2 values from immediately after irradiation were 83% of those measured 24h post-irradiation. At 1h after irradiation, the R2 values were 87% of those at 24h indicating that polymerization of the gel was still ongoing. At 24h postirradiation the width of the 80/20 penumbra on the left field edge measured 6.5 mm and on the right 5.6 mm. Conclusion: The MR-Linac allows for MR imaging during treatment and measurements of 3D dose distributions with steep dose gradients without having to transfer dosimeters for read-out. The results showed promise for polymer gels as relative 3D QA devices to verify radiation treatment plans delivered by an MR-Linac. To our knowledge, this was the first time that polymer gels were used for real-time image acquisition. Further investigations into the application of polymer gel dosimetry on MR-Linac are ongoing.

60 APPLIED LIFE SCIENCES↗

MO-AB-BRA-09: Development and Evaluation of a Biomechanical Modeling-Assisted CBCT Reconstruction Technique (Bio-Recon)

Purpose: To develop a Bio-recon technique by incorporating the biomechanical properties of anatomical structures into the deformation-based CBCT reconstruction process. Methods: Bio-recon reconstructs the CBCT by deforming a prior high-quality CT/CBCT using a deformation-vector-field (DVF). The DVF is solved through two alternating steps: 2D–3D deformation and finite-element-analysis based biomechanical modeling. 2D–3D deformation optimizes the DVF through an ‘intensity-driven’ approach, which updates the DVF to minimize intensity mismatches between the acquired projections and the simulated projections from the deformed CBCT. In contrast, biomechanical modeling optimizes the DVF through a ‘biomechanical-feature-driven’ approach, which updates the DVF based on the biophysical properties of anatomical structures. In general, Biorecon extracts the 2D–3D deformation-optimized DVF at high-contrast structure boundaries, and uses it as the boundary condition to drive biomechanical modeling to optimize the overall DVF, especially at low-contrast regions. The optimized DVF is fed back into the 2D–3D deformation for further optimization, which forms an iterative loop. The efficacy of Bio-recon was evaluated on 11 lung patient cases, each with a prior CT and a new CT. Cone-beam projections were generated from the new CTs to reconstruct CBCTs, which were compared with the original new CTs for evaluation. 872 anatomical landmarks were also manually identified by a clinician on both the prior and new CTs to track the lung motion, which was used to evaluate the DVF accuracy. Results: Using 10 projections for reconstruction, the average (± s.d.) relative errors of reconstructed CBCTs by the clinical FDK technique, the 2D–3D deformation-only technique and Bio-recon were 46.5±5.9%, 12.0±2.3% and 10.4±1.3%, respectively. The average residual errors of DVF-tracked landmark motion by the 2D–3D deformation-only technique and Bio-recon were 5.6±4.3mm and 3.1±2.4mm, respectively. Conclusion: Bio-recon improved accuracy for both the reconstructed CBCT and the DVF. The accurate DVF can benefit multiple clinical practices, such as image-guided adaptive radiotherapy. We acknowledge funding support from the American Cancer Society (RSG-13-326-01-CCE), from the US National Institutes of Health (R01 EB020366), and from the Cancer Prevention and Research Institute of Texas (RP130109).

60 APPLIED LIFE SCIENCES↗

MO-DE-207B-05: Predicting Gene Mutations in Renal Cell Carcinoma Based On CT Imaging Features: Validation Using TCGA-TCIA Datasets

Purpose: The goal of this work is to investigate the use of contrast enhanced computed tomographic (CT) features for the prediction of mutations of BAP1, PBRM1, and VHL genes in renal cell carcinoma (RCC). Methods: For this study, we used two patient databases with renal cell carcinoma (RCC). The first one consisted of 33 patients from our institution (UT Southwestern Medical Center, UTSW). The second one consisted of 24 patients from the Cancer Imaging Archive (TCIA), where each patient is connected by a unique identi?er to the tissue samples from the Cancer Genome Atlas (TCGA). From the contrast enhanced CT image of each patient, tumor contour was first delineated by a physician. Geometry, intensity, and texture features were extracted from the delineated tumor. Based on UTSW dataset, we completed feature selection and trained a support vector machine (SVM) classifier to predict mutations of BAP1, PBRM1 and VHL genes. We then used TCIA-TCGA dataset to validate the predictive model build upon UTSW dataset. Results: The prediction accuracy of gene expression of TCIA-TCGA patients was 0.83 (20 of 24), 0.83 (20 of 24), and 0.75 (18 of 24) for BAP1, PBRM1, and VHL respectively. For BAP1 gene, texture feature was the most prominent feature type. For PBRM1 gene, intensity feature was the most prominent. For VHL gene, geometry, intensity, and texture features were all important. Conclusion: Using our feature selection strategy and models, we achieved predictive accuracy over 0.75 for all three genes under the condition of using patient data from one institution for training and data from other institutions for testing. These results suggest that radiogenomics can be used to aid in prognosis and used as convenient surrogates for expensive and time consuming gene assay procedures.

60 APPLIED LIFE SCIENCES↗

MO-FG-CAMPUS-IeP2-04: Multiple Penalties with Different Orders for Structure Adaptive CBCT Reconstruction

Purpose: To combine total variation (TV) and Hessian penalty in a structure adaptive way for cone-beam CT (CBCT) reconstruction. Methods: TV is a widely used first order penalty with good ability in suppressing noise and preserving edges but leads to the staircase effect in regions with smooth intensity transition. The second order Hessian penalty can effectively suppress the staircase effect with extra cost of blurring object edges. To take the best of both penalties we proposed a novel method to combine both for CBCT reconstruction in a structure adaptive way. The proposed method adaptively determined the weight of each penalty according to the geometry of local regions. An specially-designed exponent term with image gradient involved was used to characterize the local geometry such that the weights for Hessian and TV were 1 and 0 respectively at uniform local regions and 0 and 1 at edge regions. For other local regions the weights varied from 0 to 1. The objective functional was minimized using the majorzationminimization approach. We evaluated the proposed method on a modified 3D shepp-logan and a CatPhan 600 phantom. The full-width-at-halfmaximum (FWHM) and contrast-to-noise (CNR) were calculated. Results: For 3D shepp-logan the reconstructed images using TV had an obvious staircase effect while those using the proposed method and Hessian preserved the smooth transition regions well. FWHMs of the proposed method TV and Hessian penalty were 1.75 1.61 and 3.16 respectively, indicating that both TV and the proposed method is able to preserve edges. For CatPhan 600 CNR values of the proposed method were similar to those of TV and Hessian. Conclusion: The proposed method retains favorable properties of TV like preserving edges and also has the ability in better preserving gradual transition structure as Hessian does. All methods performs similarly in suppressing noise. This work was supported in part by National Natural Science Foundation of China (NNSFC) under Grant Nos.60971112 and 61375018 grants from the Cancer Prevention and Research Institute of Texas (RP130109 and RP110562-P2) National Institute of Biomedical Imaging and Bioengineering (R01 EB020366) and a grant from the American Cancer Society (RSG-13-326-01-CCE).

60 APPLIED LIFE SCIENCES↗

TU-AB-202-05: GPU-Based 4D Deformable Image Registration Using Adaptive Tetrahedral Mesh Modeling

Purpose: Deformable image registration (DIR) has been employed today as an automated and effective segmentation method to transfer tumor or organ contours from the planning image to daily images, instead of manual segmentation. However, the computational time and accuracy of current DIR approaches are still insufficient for online adaptive radiation therapy (ART), which requires real-time and high-quality image segmentation, especially in a large datasets of 4D-CT images. The objective of this work is to propose a new DIR algorithm, with fast computational speed and high accuracy, by using adaptive feature-based tetrahedral meshing and GPU-based parallelization. Methods: The first step is to generate the adaptive tetrahedral mesh based on the image features of a reference phase of 4D-CT, so that the deformation can be well captured and accurately diffused from the mesh vertices to voxels of the image volume. Subsequently, the deformation vector fields (DVF) and other phases of 4D-CT can be obtained by matching each phase of the target 4D-CT images with the corresponding deformed reference phase. The proposed 4D DIR method is implemented on GPU, resulting in significantly increasing the computational efficiency due to its parallel computing ability. Results: A 4D NCAT digital phantom was used to test the efficiency and accuracy of our method. Both the image and DVF results show that the fine structures and shapes of lung are well preserved, and the tumor position is well captured, i.e., 3D distance error is 1.14 mm. Compared to the previous voxel-based CPU implementation of DIR, such as demons, the proposed method is about 160x faster for registering a 10-phase 4D-CT with a phase dimension of 256×256×150. Conclusion: The proposed 4D DIR method uses feature-based mesh and GPU-based parallelism, which demonstrates the capability to compute both high-quality image and motion results, with significant improvement on the computational speed.

60 APPLIED LIFE SCIENCES↗

TU-H-BRC-06: Temperature Simulation of Tungsten and W25Re Targets to Deliver High Dose Rate 10 MV Photons

Purpose: To study the impact of electron beam size, target thickness, and target temperature on the ability of the flattening filter-free mode (FFF) treatment head to deliver high-dose-rate irradiations. Methods: The dose distribution and transient temperature of the X-ray target under 10 MeV electron beam with pulse length of 5 microseconds, and repetition rate of 1000 Hz was studied. A MCNP model was built to calculate the percentage depth dose (PPD) distribution in a water phantom at a distance of 100 cm. ANSYS software was used to run heat transfer simulations. The PPD and temperature for both tungsten and W25Re targets for different electron beam sizes (FHWM 0.2, 0.5, 1 and 2 mm) and target thickness (0.2 to 2 mm) were studied. Results: Decreasing the target thickness from 1 mm to 0.5 mm, caused a surface dose increase about 10 percent. For both target materials, the peak temperature was about 1.6 times higher for 0.5 mm electron beam compared to the 1 mm beam after reaching their equilibrium. For increasing target thicknesses, the temperature rise caused by the first pulse is similar for all thicknesses, however the temperature difference for subsequent pulses becomes larger until a constant ratio is reached. The target peak temperature after reaching equilibrium can be calculated by adding the steady state temperature and the amplitude of the temperature oscillation. Conclusion: This work indicates the potential to obtain high dose rate irradiation by selecting target material, geometry and electron beam parameters. W25Re may not outperformed tungsten when the target is thick due to its relatively low thermal conductivity. The electron beam size only affects the target temperature but not the PPD. Thin target is preferred to obtain high dose rate and low target temperature, however, the resulting high surface dose is a major concern. NIH funding:R21 EB015957-01; DOD funding:W81XWH-13-1-0165 BL, PM, PB, and RF are founders of TibaRay, Inc. BL is also a borad member. BL and PM have received research grants from Varian Medical System, Inc. and RaySearch Laboratory. RF is an employee of Siemens Healthcare GmbH.

60 APPLIED LIFE SCIENCES↗

TU-H-BRC-09: Validation of a Novel Therapeutic X-Ray Array Source and Collimation System

Purpose: We have experimentally characterized and simulated the dosimetric properties and spatial fidelity of a novel X-ray array source and collimation system called SPHINX that has the potential to generate complex intensity modulated X-ray beams by varying the electron beam intensity only, and without any moving parts like in multi-leaf collimators. Methods: We investigated the spatial fidelity and the X-ray performances of a SPHINX prototype in tungsten, using a Cyber Knife and the experimental high-energy electron beam line at XTA at SLAC National Laboratory. Dose distributions were recorded with gafchromic films, placed at the distal end of SPHINX and at several depths in a solid water phantom. The geometry of SPHINX and of the experimental set-ups was also modeled in Monte Carlo (MC) simulations with the FLUKA code, used to reproduce the experimental results and, after validation, to predict and optimize the performance and design of the SPHINX. Results: The results indicate significant particle leakage through the channels during a single-channel irradiation for high incident energies, followed by a rapid decrease for energies of clinical interest. When the collimator channels are used as target, the photon production increases, however at expense of the beam size that is also enlarged. The illumination of all channels simultaneously shows a fairly even transmission of the beam. Conclusion: With the measurements we have verified the MC models and the uniformity of beam transmission through SPHINX, and we have evaluated the importance of particle leakage through adjacent channels. These results can be used to optimize SPHINX design through the validated MC simulations. Funding: Weston Havens Foundation, Office of the Dean of Medical School and Office of the Provost (Stanford University). Loo, Maxim, Borchard, Tantawi are co-founders of TibaRay Inc. Loo and Tantawi are TibaRay Inc. board members. Loo and Maxim received grants from Varian Medical Systems and RaySearch Laboratory.

60 APPLIED LIFE SCIENCES↗