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Winey, Brian

Publications and source records attributed to Winey, Brian.

Mapping {sup 15}O Production Rate for Proton Therapy Verification

Purpose: This work was a proof-of-principle study for the evaluation of oxygen-15 ({sup 15}O) production as an imaging target through the use of positron emission tomography (PET), to improve verification of proton treatment plans and to study the effects of perfusion. Methods and Materials: Dynamic PET measurements of irradiation-produced isotopes were made for a phantom and rabbit thigh muscles. The rabbit muscle was irradiated and imaged under both live and dead conditions. A differential equation was fitted to phantom and in vivo data, yielding estimates of {sup 15}O production and clearance rates, which were compared to live versus dead rates for the rabbit and to Monte Carlo predictions. Results: PET clearance rates agreed with decay constants of the dominant radionuclide species in 3 different phantom materials. In 2 oxygen-rich materials, the ratio of {sup 15}O production rates agreed with the expected ratio. In the dead rabbit thighs, the dynamic PET concentration histories were accurately described using {sup 15}O decay constant, whereas the live thigh activity decayed faster. Most importantly, the {sup 15}O production rates agreed within 2% (P>.5) between conditions. Conclusions: We developed a new method for quantitative measurement of {sup 15}O production and clearance rates in the period immediately following proton therapy. Measurements in the phantom and rabbits were well described in terms of {sup 15}O production and clearance rates, plus a correction for other isotopes. These proof-of-principle results support the feasibility of detailed verification of proton therapy treatment delivery. In addition, {sup 15}O clearance rates may be useful in monitoring permeability changes due to therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Long-term stability and mechanical characteristics of kV digital imaging system for proton radiotherapy

Purpose: To quantitatively evaluate the long-term image panel positioning stability and gantry angle dependence for gantry-mounted kV imaging systems. Methods: For patient setup digital imaging systems in isocentric rotating proton beam delivery facilities, physical crosshairs are commonly inserted into the snout to define the kV x-ray beam isocenter. Utilizing an automatic detection algorithm, the authors analyzed the crosshair center positions in 2744 patient setup kV images acquired with the four imagers in two treatment rooms from January 2012 to January 2013. The crosshair position was used as a surrogate for imaging panel position, and its long-term stability at the four cardinal angles and the panel flex dependency on gantry angle was investigated. Results: The standard deviation of the panel position distributions was within 0.32 mm (with the range of variation less than ± 1.4 mm) in both the X-Z plane and Y direction. The mean panel inplane rotations were not more than 0.51° for the four panels at the cardinal angles, with standard deviations ≤0.26°. The panel position variations with gantry rotation due to gravity (flex) were within ±4 mm, and were panel-specific. Conclusions: The authors demonstrated that the kV image panel positions in our proton treatment system were highly reproducible at the cardinal angles over 13 months and also that the panel positions can be correlated to gantry angles. This result indicates that the kV image panel positions are stable over time; the amount of panel sag is predictable during gantry rotation and the physical crosshair for kV imaging may eventually be removed, with the imaging beam isocenter position routinely verified by adequate quality assurance procedures and measurements.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A fast double template convolution isocenter evaluation algorithm with subpixel accuracy

Purpose: To design a fast Winston Lutz (fWL) algorithm for accurate analysis of radiation isocenter from images without edge detection or center of mass calculations. Methods: An algorithm has been developed to implement the Winston Lutz test for mechanical/radiation isocenter agreement using an electronic portal imaging device (EPID). The algorithm detects the position of the radiation shadow of a tungsten ball within a stereotactic cone. The fWL algorithm employs a double convolution to independently find the position of the sphere and cone centers. Subpixel estimation is used to achieve high accuracy. Results of the algorithm were compared to (1) a human observer with template guidance and (2) an edge detection/center of mass (edCOM) algorithm. Testing was performed with high resolution (0.05mm/px, film) and low resolution (0.78mm/px, EPID) image sets. Results: Sphere and cone center relative positions were calculated with the fWL algorithm for high resolution test images with an accuracy of 0.002{+-}0.061 mm compared to 0.042{+-}0.294 mm for the human observer, and 0.003{+-}0.038 mm for the edCOM algorithm. The fWL algorithm required 0.01 s per image compared to 5 s for the edCOM algorithm and 20 s for the human observer. For lower resolution images the fWL algorithm localized the centers with an accuracy of 0.083{+-}0.12 mm compared to 0.03{+-}0.5514 mm for the edCOM algorithm. Conclusions: A fast (subsecond) subpixel algorithm has been developed that can accurately determine the center locations of the ball and cone in Winston Lutz test images without edge detection or COM calculations.

60 APPLIED LIFE SCIENCES↗

Use of a realistic breathing lung phantom to evaluate dose delivery errors

Purpose: To compare the effect of respiration-induced motion on delivered dose (the interplay effect) for different treatment techniques under realistic clinical conditions. Methods: A flexible resin tumor model was created using rapid prototyping techniques based on a computed tomography (CT) image of an actual tumor. Twenty micro-MOSFETs were inserted into the tumor model and the tumor model was inserted into an anthropomorphic breathing phantom. Phantom motion was programed using the motion trajectory of an actual patient. A four-dimensional CT image was obtained and several treatment plans were created using different treatment techniques and planning systems: Conformal (Eclipse), step-and-shoot intensity-modulated radiation therapy (IMRT) (Pinnacle), step-and-shoot IMRT (XiO), dynamic IMRT (Eclipse), complex dynamic IMRT (Eclipse), hybrid IMRT [60% conformal, 40% dynamic IMRT (Eclipse)], volume-modulated arc therapy (VMAT) [single-arc (Eclipse)], VMAT [double-arc (Eclipse)], and complex VMAT (Eclipse). The complex plans were created by artificially pushing the optimizer to give complex multileaf collimator sequences. Each IMRT field was irradiated five times and each VMAT field was irradiated ten times, with each irradiation starting at a random point in the respiratory cycle. The effect of fractionation was calculated by randomly summing the measured doses. The maximum deviation for each measurement point per fraction and the probability that 95% of the model tumor had dose deviations less than 2% and 5% were calculated as a function of the number of fractions. Tumor control probabilities for each treatment plan were calculated and compared. Results: After five fractions, measured dose deviations were less than 2% for more than 95% of measurement points within the tumor model for all plans, except the complex dynamic IMRT, step-and-shoot IMRT (XiO), complex VMAT, and single-arc VMAT plans. Reducing the dose rate of the complex IMRT plans from 600 to 200 MU/min reduced the dose deviations to less than 2%. Dose deviations were less than 5% after five fractions for all plans, except the complex single-arc VMAT plan. Conclusions: Rapid prototyping techniques can be used to create realistic tumor models. For most treatment techniques, the dose deviations averaged out after several fractions. Treatments with unusually complicated multileaf collimator sequences had larger dose deviations. For IMRT treat-ments, dose deviations can be reduced by reducing the dose rate. For VMAT treatments, using two arcs instead of one is effective for reducing dose deviations.

60 APPLIED LIFE SCIENCES↗