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At least 181 records · Page 10

SU-F-I-50: Finite Element-Based Deformable Image Registration of Lung and Heart

Purpose: Photodynamic therapy (PDT) is used after surgical resection to treat the microscopic disease for malignant pleural mesothelioma and to increase survival rates. Although accurate light delivery is imperative to PDT efficacy, the deformation of the pleural volume during the surgery impacts the delivered light dose. To facilitate treatment planning, we use a finite-element-based (FEM) deformable image registration to quantify the anatomical variation of lung and heart volumes between CT pre-(or post-) surgery and surface contours obtained during PDT using an infrared camera-based navigation system (NDI). Methods: NDI is used during PDT to obtain the information of the cumulative light fluence on every cavity surface point that is being treated. A wand, comprised of a modified endotrachial tube filled with Intralipid and an optical fiber inside the tube, is used to deliver the light during PDT. The position of the treatment is tracked using an attachment with nine reflective passive markers that are seen by the NDI system. Then, the position points are plotted as three-dimensional volume of the pleural cavity using Matlab and Meshlab. A series of computed tomography (CT) scans of the lungs and heart, in the same patient, are also acquired before and after the surgery. The NDI and CT contours are imported into COMSOL Multiphysics, where the FEM-based deformable image registration is obtained. The NDI and CT contours acquired during and post-PDT are considered as the reference, and the Pre-PDT CT contours are used as the target, which will be deformed. Results: Anatomical variation of the lung and heart volumes, taken at different times from different imaging devices, was determined by using our model. The resulting three-dimensional deformation map along x, y and z-axes was obtained. Conclusion: Our model fuses images acquired by different modalities and provides insights into the variation in anatomical structures over time.

60 APPLIED LIFE SCIENCES↗

TU-F-17A-03: An Analytical Respiratory Perturbation Model for Lung Motion Prediction

Purpose: Breathing irregularity is common, causing unreliable prediction in tumor motion for correlation-based surrogates. Both tidal volume (TV) and breathing pattern (BP=ΔVthorax/TV, where TV=ΔVthorax+ΔVabdomen) affect lung motion in anterior-posterior and superior-inferior directions. We developed a novel respiratory motion perturbation (RMP) model in analytical form to account for changes in TV and BP in motion prediction from simulation to treatment. Methods: The RMP model is an analytical function of patient-specific anatomic and physiologic parameters. It contains a base-motion trajectory d(x,y,z) derived from a 4-dimensional computed tomography (4DCT) at simulation and a perturbation term Δd(ΔTV,ΔBP) accounting for deviation at treatment from simulation. The perturbation is dependent on tumor-specific location and patient-specific anatomy. Eleven patients with simulation and treatment 4DCT images were used to assess the RMP method in motion prediction from 4DCT1 to 4DCT2, and vice versa. For each patient, ten motion trajectories of corresponding points in the lower lobes were measured in both 4DCTs: one served as the base-motion trajectory and the other as the ground truth for comparison. In total, 220 motion trajectory predictions were assessed. The motion discrepancy between two 4DCTs for each patient served as a control. An established 5D motion model was used for comparison. Results: The average absolute error of RMP model prediction in superior-inferior direction is 1.6±1.8 mm, similar to 1.7±1.6 mm from the 5D model (p=0.98). Some uncertainty is associated with limited spatial resolution (2.5mm slice thickness) and temporal resolution (10-phases). Non-corrected motion discrepancy between two 4DCTs is 2.6±2.7mm, with the maximum of ±20mm, and correction is necessary (p=0.01). Conclusion: The analytical motion model predicts lung motion with accuracy similar to the 5D model. The analytical model is based on physical relationships, requires no training, and therefore is potentially more resilient to breathing irregularities. On-going investigation introduces airflow into the RMP model for improvement. This research is in part supported by NIH (U54CA137788/132378). AY would like to thank MSKCC summer medical student research program supported by National Cancer Institute and hosted by Department of Medical Physics at MSKCC.

60 APPLIED LIFE SCIENCES↗

WE-G-207-06: 3D Fluoroscopic Image Generation From Patient-Specific 4DCBCT-Based Motion Models Derived From Physical Phantom and Clinical Patient Images

Purpose: Respiratory-correlated cone-beam CT (4DCBCT) images acquired immediately prior to treatment have the potential to represent patient motion patterns and anatomy during treatment, including both intra- and inter-fractional changes. We develop a method to generate patient-specific motion models based on 4DCBCT images acquired with existing clinical equipment and used to generate time varying volumetric images (3D fluoroscopic images) representing motion during treatment delivery. Methods: Motion models are derived by deformably registering each 4DCBCT phase to a reference phase, and performing principal component analysis (PCA) on the resulting displacement vector fields. 3D fluoroscopic images are estimated by optimizing the resulting PCA coefficients iteratively through comparison of the cone-beam projections simulating kV treatment imaging and digitally reconstructed radiographs generated from the motion model. Patient and physical phantom datasets are used to evaluate the method in terms of tumor localization error compared to manually defined ground truth positions. Results: 4DCBCT-based motion models were derived and used to generate 3D fluoroscopic images at treatment time. For the patient datasets, the average tumor localization error and the 95th percentile were 1.57 and 3.13 respectively in subsets of four patient datasets. For the physical phantom datasets, the average tumor localization error and the 95th percentile were 1.14 and 2.78 respectively in two datasets. 4DCBCT motion models are shown to perform well in the context of generating 3D fluoroscopic images due to their ability to reproduce anatomical changes at treatment time. Conclusion: This study showed the feasibility of deriving 4DCBCT-based motion models and using them to generate 3D fluoroscopic images at treatment time in real clinical settings. 4DCBCT-based motion models were found to account for the 3D non-rigid motion of the patient anatomy during treatment and have the potential to localize tumor and other patient anatomical structures at treatment time even when inter-fractional changes occur. This project was supported, in part, through a Master Research Agreement with Varian Medical Systems, Inc., Palo Alto, CA. The project was also supported, in part, by Award Number R21CA156068 from the National Cancer Institute.

60 APPLIED LIFE SCIENCES↗

A reduced order model to analytically infer atmospheric CO 2 concentration from stomatal and climate data

To address questions related to the acceleration or deceleration of the global hydrological cycle or links between the carbon and water cycles over land, reliable data for past climatic conditions based on proxies are required. In particular, the reconstruction of palaeoatmospheric CO 2 content (C a ) is needed to assist the separation of natural from anthropogenic C a variability and to explore phase relations between C a and air temperature T a time series. Both T a and C a are needed to fingerprint anthropogenic signatures in vapor pressure deficit, a major driver used to explain acceleration or deceleration phases in the global hydrological cycle. Current approaches to C a reconstruction rely on a robust inverse correlation between measured stomatal density in leaves (ν) of many plant taxa and C a . There are two methods that exploit this correlation: The first uses calibration curves obtained from extant species assumed to represent the fossil taxa, thereby restricting the suitable taxa to those existing today. The second is a hybrid eco-hydrological/physiological approach that determines C a with the aid of systems of equations based on quasi-instantaneous leaf-gas exchange theories and fossil stomatal data collected along with other measured leaf anatomical traits and parameters. In this contribution, a reduced order model (ROM) is proposed that derives C a from a single equation incorporating the aforementioned stomatal data, basic climate (e.g. temperature), estimated biochemical parameters of assimilation and isotope data. The usage of the ROM is then illustrated by applying it to isotopic and anatomical measurements from three extant species. The ROM derivation is based on a balance between the biochemical demand and atmospheric supply of CO 2 that leads to an explicit expression linking stomatal conductance to internal CO 2 concentration (C i ) and C a . The resulting expression of stomatal conductance from the carbon economy of the leaf is then equated to another expression derived from water vapor gas diffusion that includes anatomical traits. When combined with isotopic measurements for long-term C i /C a , C a can be analytically determined and is interpreted as the time-averaged C a that existed over the life-span of the leaf. Key advantages of the proposed ROM are: 1) the usage of isotopic data provides constraints on the reconstructed atmospheric CO 2 concentration from ν, 2) the analytical form of this approach permits direct links between parameter uncertainties and reconstructed C a , and 3) the time-scale mismatch between the application of instantaneous leaf-gas exchange expressions constrained with longer-term isotopic data is reconciled through averaging rules and sensitivity analysis. The latter point was rarely considered in prior reconstruction studies that combined models of leaf-gas exchange and isotopic data to reconstruct C a from ν. The proposed ROM is not without its limitations given the need to a priori assume a parameter related to the control on photosynthetic rate. Our work here further explores immanent constraints for the aforementioned photosynthetic parameter.

54 ENVIRONMENTAL SCIENCES↗

The development of a population of 4D pediatric XCAT phantoms for imaging research and optimization

Purpose: We previously developed a set of highly detailed 4D reference pediatric extended cardiac-torso (XCAT) phantoms at ages of newborn, 1, 5, 10, and 15 yr with organ and tissue masses matched to ICRP Publication 89 values. In this work, we extended this reference set to a series of 64 pediatric phantoms of varying age and height and body mass percentiles representative of the public at large. The models will provide a library of pediatric phantoms for optimizing pediatric imaging protocols. Methods: High resolution positron emission tomography-computed tomography data obtained from the Duke University database were reviewed by a practicing experienced radiologist for anatomic regularity. The CT portion of the data was then segmented with manual and semiautomatic methods to form a target model defined using nonuniform rational B-spline surfaces. A multichannel large deformation diffeomorphic metric mapping algorithm was used to calculate the transform from the best age matching pediatric XCAT reference phantom to the patient target. The transform was used to complete the target, filling in the nonsegmented structures and defining models for the cardiac and respiratory motions. The complete phantoms, consisting of thousands of structures, were then manually inspected for anatomical accuracy. The mass for each major tissue was calculated and compared to linearly interpolated ICRP values for different ages. Results: Sixty four new pediatric phantoms were created in this manner. Each model contains the same level of detail as the original XCAT reference phantoms and also includes parameterized models for the cardiac and respiratory motions. For the phantoms that were 10 yr old and younger, we included both sets of reproductive organs. This gave them the capability to simulate both male and female anatomy. With this, the population can be expanded to 92. Wide anatomical variation was clearly seen amongst the phantom models, both in organ shape and size, even for models of the same age and sex. The phantoms can be combined with existing simulation packages to generate realistic pediatric imaging data from different modalities. Conclusions: This work provides a large cohort of highly detailed pediatric phantoms with 4D capabilities of varying age, height, and body mass. The population of phantoms will provide a vital tool with which to optimize 3D and 4D pediatric imaging devices and techniques in terms of image quality and radiation-absorbed dose.

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↗

SU-E-J-44: Design a Platform and Phantom Model for Photoacoustic Imaging in Combination with CT

Purpose: Our (long-term) objective is to develop a US manipulator that will provide in situ radiation response and image-guided therapy for bladder cancer based on photoacoustic molecular imaging. Methods: A platform was devised to provide a reproducible positional frame of reference for targeting anatomic structure between MDCT and US scans, in lieu of CBCT, and to fuse photoacoustic molecular imaging. US and photoacoustic scans are taken of a patient while in the CT scanner and IRMT. Through co-registration, based on anatomical positions, we identified a common coordinate system to be used in Eclipse. A bladder phantom was constructed to validate anatomical tracking via US and photoacoustic imaging. We tested the platform using phantom model to demonstrate validity once moved from the CT couch to the linear accelerator couch. Results: This platform interlocks with Varian exact couch index points for reproducibility of positioning. Construction from low Z material and sized appropriately to fit in CT/IMRT gantry. Error in conversion from cylindrical coordinates of the manipulator to X, Y, Z coordinates of the treatment couch was less than 1mm. We measured the bladder size in 3 different directions in both Eclipse from the CT and Acuson from US. The error was less than 2mm in all directions. CT and US images were co-registered in MATLAB. Co-registration of photoacoustic images is still being developed. Conclusion: For Linear Accelerators without on board imaging, MV portal images are not a viable option for the localization of soft tissue anatomy. We believe our manipulator provides an alternative using US imaging, which will be examined in an upcoming clinical trial. We plan to examine the value of hypoxia guided treatment through photoacoustic imaging during this trial.

60 APPLIED LIFE SCIENCES↗

Efficient Computational Modeling of Human Ventricular Activation and Its Electrocardiographic Representation: A Sensitivity Study

Patient-specific models of the ventricular myocardium, combined with the computational power to run rapid simulations, are approaching the level where they could be used for personalized cardiovascular medicine. A major remaining challenge is determining model parameters from available patient data, especially for models of the Purkinje-myocardial junctions (PMJs): the sites of initial ventricular electrical activation. There are no non-invasive methods for localizing PMJs in patients, and the relationship between the standard clinical ECG and PMJ model parameters is underexplored. Thus, this study aimed to determine the sensitivity of the QRS complex of the ECG to the anatomical location and regional number of PMJs. The QRS complex was simulated using an image-based human torso and biventricular model, and cardiac electrophysiology was simulated using Cardioid. The PMJs were modeled as discrete current injection stimuli, and the location and number of stimuli were varied within initial activation regions based on published experiments. Results indicate that the QRS complex features were most sensitive to the presence or absence of four “seed” stimuli, and adjusting locations of nearby “regional” stimuli provided finer tuning. Decreasing number of regional stimuli by an order of magnitude resulted in virtually no change in the QRS complex. Thus, a minimal 12-stimuli configuration was identified that resulted in physiological excitation, defined by QRS complex feature metrics and ventricular excitation pattern. In conclusion, overall, the sensitivity results suggest that parameterizing PMJ location, rather than number, be given significantly higher priority in future studies creating personalized ventricular models from patient-derived ECGs.

59 BASIC BIOLOGICAL SCIENCES↗

SU-E-J-115: Using Markov Chain Modeling to Elucidate Patterns in Breast Cancer Metastasis Over Time and Space

Purpose: Traditionally, breast cancer metastasis is described as a process wherein cancer cells spread from the breast to multiple organ systems via hematogenous and lymphatic routes. Mapping organ specific patterns of cancer spread over time is essential to understanding metastatic progression. In order to better predict sites of metastases, here we demonstrate modeling of the patterned migration of metastasis. Methods: We reviewed the clinical history of 453 breast cancer patients from Memorial Sloan Kettering Cancer Center who were non-metastatic at diagnosis but developed metastasis over time. We used the variables of organ site of metastases as well as time to create a Markov chain model of metastasis. We illustrate the probabilities of metastasis occurring at a given anatomic site together with the probability of spread to additional sites. Results: Based on the clinical histories of 453 breast cancer patients who developed metastasis, we have learned (i) how to create the Markov transition matrix governing the probabilities of cancer progression from site to site; (ii) how to create a systemic network diagram governing disease progression modeled as a random walk on a directed graph; (iii) how to classify metastatic sites as ‘sponges’ that tend to only receive cancer cells or ‘spreaders’ that receive and release them; (iv) how to model the time-scales of disease progression as a Weibull probability distribution function; (v) how to perform Monte Carlo simulations of disease progression; and (vi) how to interpret disease progression as an entropy-increasing stochastic process. Conclusion: Based on our modeling, metastatic spread may follow predictable pathways. Mapping metastasis not simply by organ site, but by function as either a ‘spreader’ or ‘sponge’ fundamentally reframes our understanding of metastatic processes. This model serves as a novel platform from which we may integrate the evolving genomic landscape that drives cancer metastasis. PS-OC Trans-Network Project Grant Award for “Data Assimilation and ensemble statistical forecasting methods applied to the MSKCC longitudinal metastatic breast cancer cohort.”.

60 APPLIED LIFE SCIENCES↗

A porcine ligated loop model reveals new insight into the host immune response against Campylobacter jejuni

The symptoms of infectious diarrheal disease are mediated by a combination of a pathogen’s virulence factors and the host immune system. Campylobacter jejuni is the leading bacterial cause of diarrhea worldwide due to its near-ubiquitous zoonotic association with poultry. One of the outstanding questions is to what extent the bacteria are responsible for the diarrheal symptoms via intestinal cell necrosis versus immune cell initiated tissue damage. To determine the stepwise process of inflammation that leads to diarrhea, we used a piglet ligated intestinal loop model to study the intestinal response to C. jejuni. Pigs were chosen due to the anatomical similarity between the porcine and the human intestine. We found that the abundance of neutrophil related proteins increased in the intestinal lumen during C. jejuni infection, including proteins related to neutrophil migration (neutrophil elastase and MMP9), actin reorganization (Arp2/3), and antimicrobial proteins (lipocalin-2, myeloperoxidase, S100A8, and S100A9). The appearance of neutrophil proteins also corresponded with increases of the inflammatory cytokines IL-8 and TNF-a. Compared to infection with the C. jejuni wild-type strain, infection with the noninvasive C. jejuni ?ciaD mutant resulted in a blunted inflammatory response, with less inflammatory cytokines and neutrophil markers. These findings indicate that intestinal inflammation is driven by C. jejuni virulence and that neutrophils are the predominant cell type responding to C. jejuni infection. We propose that this model can be used as a platform to study the early immune events during infection with intestinal pathogens.

disease model, INNATE IMMUNITY, proteomics, intest↗

Ultrasound guided fluorescence molecular tomography with improved quantification by an attenuation compensated born-normalization and in vivo preclinical study of cancer

Ultrasound imaging, having the advantages of low-cost and non-invasiveness over MRI and X-ray CT, was reported by several studies as an adequate complement to fluorescence molecular tomography with the perspective of improving localization and quantification of fluorescent molecular targets in vivo. Based on the previous work, an improved dual-modality Fluorescence-Ultrasound imaging system was developed and then validated in imaging study with preclinical tumor model. Ultrasound imaging and a profilometer were used to obtain the anatomical prior information and 3D surface, separately, to precisely extract the tissue boundary on both sides of sample in order to achieve improved fluorescence reconstruction. Furthermore, a pattern-based fluorescence reconstruction on the detection side was incorporated to enable dimensional reduction of the dataset while keeping the useful information for reconstruction. Due to its putative role in the current imaging geometry and the chosen reconstruction technique, we developed an attenuation compensated Born-normalization method to reduce the attenuation effects and cancel off experimental factors when collecting quantitative fluorescence datasets over large area. Results of both simulation and phantom study demonstrated that fluorescent targets could be recovered accurately and quantitatively using this reconstruction mechanism. Finally, in vivo experiment confirms that the imaging system associated with the proposed image reconstruction approach was able to extract both functional and anatomical information, thereby improving quantification and localization of molecular targets.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A “loop” shape descriptor and its application to automated segmentation of airways from CT scans

Purpose: A novel shape descriptor is presented to aid an automated identification of the airways depicted on computed tomography (CT) images. Methods: Instead of simplifying the tubular characteristic of the airways as an ideal mathematical cylindrical or circular shape, the proposed “loop” shape descriptor exploits the fact that the cross sections of any tubular structure (regardless of its regularity) always appear as a loop. In implementation, the authors first reconstruct the anatomical structures in volumetric CT as a three-dimensional surface model using the classical marching cubes algorithm. Then, the loop descriptor is applied to locate the airways with a concave loop cross section. To deal with the variation of the airway walls in density as depicted on CT images, a multiple threshold strategy is proposed. A publicly available chest CT database consisting of 20 CT scans, which was designed specifically for evaluating an airway segmentation algorithm, was used for quantitative performance assessment. Measures, including length, branch count, and generations, were computed under the aid of a skeletonization operation. Results: For the test dataset, the airway length ranged from 64.6 to 429.8 cm, the generation ranged from 7 to 11, and the branch number ranged from 48 to 312. These results were comparable to the performance of the state-of-the-art algorithms validated on the same dataset. Conclusions: The authors’ quantitative experiment demonstrated the feasibility and reliability of the developed shape descriptor in identifying lung airways.

60 APPLIED LIFE SCIENCES↗

Noise, sampling, and the number of projections in cone-beam CT with a flat-panel detector

Purpose: To investigate the effect of the number of projection views on image noise in cone-beam CT (CBCT) with a flat-panel detector. Methods: This fairly fundamental consideration in CBCT system design and operation was addressed experimentally (using a phantom presenting a uniform medium as well as statistically motivated “clutter”) and theoretically (using a cascaded systems model describing CBCT noise) to elucidate the contributing factors of quantum noise (σ{sub Q}), electronic noise (σ{sub E}), and view aliasing (σ{sub view}). Analysis included investigation of the noise, noise-power spectrum, and modulation transfer function as a function of the number of projections (N{sub proj}), dose (D{sub tot}), and voxel size (b{sub vox}). Results: The results reveal a nonmonotonic relationship between image noise andN{sub proj} at fixed total dose: for the CBCT system considered, noise decreased with increasing N{sub proj} due to reduction of view sampling effects in the regime N{sub proj} <∼200, above which noise increased with N{sub proj} due to increased electronic noise. View sampling effects were shown to depend on the heterogeneity of the object in a direct analytical relationship to power-law anatomical clutter of the form κ/f {sup β}—and a general model of individual noise components (σ{sub Q}, σ{sub E}, and σ{sub view}) demonstrated agreement with measurements over a broad range in N{sub proj}, D{sub tot}, and b{sub vox}. Conclusions: The work elucidates fairly basic elements of CBCT noise in a manner that demonstrates the role of distinct noise components (viz., quantum, electronic, and view sampling noise). For configurations fairly typical of CBCT with a flat-panel detector (FPD), the analysis reveals a “sweet spot” (i.e., minimum noise) in the rangeN{sub proj} ∼ 250–350, nearly an order of magnitude lower in N{sub proj} than typical of multidetector CT, owing to the relatively high electronic noise in FPDs. The analysis explicitly relates view aliasing and quantum noise in a manner that includes aspects of the object (“clutter”) and imaging chain (including nonidealities of detector blur and electronic noise) to provide a more rigorous basis for commonly held intuition and heurism in CBCT system design and operation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-E-T-272: Direct Verification of a Treatment Planning System Megavoltage Linac Beam Photon Spectra Models, and Analysis of the Effects On Patient Plans

Purpose: For the photon dose calculation Philips Pinnacle Treatment Planning System (TPS) uses collapsed cone convolution algorithm, which relies on energy spectrum of the beam in computing the scatter component. The spectrum is modeled based on Linac’s standard commissioning data and typically is not independently verified. We explored a methodology of using transmission measurements in combination with regularization data processing to unfold Linac spectra. The measured spectra were compared to those modeled by the TPS, and the effect on patient plans was evaluated. Methods: Transmission measurements were conducted in narrow-beam geometry using a standard Farmer ionization chamber. Two attenuating materials and two build -up caps, having different atomic numbers, served to enhance discrimination between absorption of low and high-energy portions of the spectra, thus improving the accuracy of the results. The data was analyzed using a regularization technique implemented through spreadsheet-based calculations. Results: The unfolded spectra were found to deviate from the TPS beam models. The effect of such deviations on treatment planning was evaluated for patient plans through dose distribution calculations with either TPS modeled or measured energy spectra. The differences were reviewed through comparison of isodose distributions, and quantified based on maximum dose values for critical structures. While in most cases no drastic differences in the calculated doses were observed, plans with deviations of 4 to 8% in the maximum dose values for critical structures were discovered. The anatomical sites with large scatter contributions are the most vulnerable to inaccuracies in the modeled spectrum. Conclusion: An independent check of the TPS model spectrum is highly desirable and should be included as part of commissioning of a new Linac. The effect is particularly important for dose calculations in high heterogeneity regions. The developed approach makes acquisition of megavoltage Linac beam spectra achievable in a typical radiation oncology clinic.

60 APPLIED LIFE SCIENCES↗

SU-D-BRA-04: Computerized Framework for Marker-Less Localization of Anatomical Feature Points in Range Images Based On Differential Geometry Features for Image-Guided Radiation Therapy

Purpose: To propose a computerized framework for localization of anatomical feature points on the patient surface in infrared-ray based range images by using differential geometry (curvature) features. Methods: The general concept was to reconstruct the patient surface by using a mathematical modeling technique for the computation of differential geometry features that characterize the local shapes of the patient surfaces. A region of interest (ROI) was firstly extracted based on a template matching technique applied on amplitude (grayscale) images. The extracted ROI was preprocessed for reducing temporal and spatial noises by using Kalman and bilateral filters, respectively. Next, a smooth patient surface was reconstructed by using a non-uniform rational basis spline (NURBS) model. Finally, differential geometry features, i.e. the shape index and curvedness features were computed for localizing the anatomical feature points. The proposed framework was trained for optimizing shape index and curvedness thresholds and tested on range images of an anthropomorphic head phantom. The range images were acquired by an infrared ray-based time-of-flight (TOF) camera. The localization accuracy was evaluated by measuring the mean of minimum Euclidean distances (MMED) between reference (ground truth) points and the feature points localized by the proposed framework. The evaluation was performed for points localized on convex regions (e.g. apex of nose) and concave regions (e.g. nasofacial sulcus). Results: The proposed framework has localized anatomical feature points on convex and concave anatomical landmarks with MMEDs of 1.91±0.50 mm and 3.70±0.92 mm, respectively. A statistically significant difference was obtained between the feature points on the convex and concave regions (P<0.001). Conclusion: Our study has shown the feasibility of differential geometry features for localization of anatomical feature points on the patient surface in range images. The proposed framework might be useful for tasks involving feature-based image registration in range-image guided radiation therapy.

60 APPLIED LIFE SCIENCES↗

SU-E-J-91: Biomechanical Deformable Image Registration of Longitudinal Lung CT Images

Purpose: Spatial correlation of lung tissue across longitudinal images, as the patient responds to treatment, is a critical step in adaptive radiotherapy. The goal of this work is to expand a biomechanical model-based deformable registration algorithm (Morfeus) to achieve accurate registration in the presence of significant anatomical changes. Methods: Four lung cancer patients previously treated with conventionally fractionated radiotherapy that exhibited notable tumor shrinkage during treatment were retrospectively evaluated. Exhale breathhold CT scans were obtained at treatment planning (PCT) and following three weeks (W3CT) of treatment. For each patient, the PCT was registered to the W3CT using Morfeus, a biomechanical model-based deformable registration algorithm, consisting of boundary conditions on the lungs and incorporating a sliding interface between the lung and chest wall. To model the complex response of the lung, an extension to Morfeus has been developed: (i) The vessel tree was segmented by thresholding a vesselness image based on the Hessian matrix’s eigenvalues and the centerline was extracted; (ii) A 3D shape context method was used to find correspondences between the trees of the two images; (ii) Correspondences were used as additional boundary conditions (Morfeus+vBC). An expert independently identified corresponding landmarks well distributed in the lung to compute Target Registration Errors (TRE). Results: The TRE within 15mm of the tumor boundaries (on average 11 landmarks) is: 6.1±1.8, 4.6±1.1 and 3.8±2.3 mm after rigid registration, Morfeus and Morfeus+vBC, respectively. The TRE in the rest of the lung (on average 13 landmarks) is: 6.4±3.9, 4.7±2.2 and 3.6±1.9 mm, which is on the order of the 2mm isotropic dose grid vector (3.5mm). Conclusion: The addition of boundary conditions on the vessels improved the accuracy in modeling the response of the lung and tumor over the course of radiotherapy. Minimizing and modeling these geometrical uncertainties will enable future plan adaptation strategies. This work was funded in part by NIH 2P01CA059827-16.

60 APPLIED LIFE SCIENCES↗

Simulation of Blast and Behind-Armor Blunt Trauma to Life-Critical Organs in the Human Body [Poster]

Researchers at Sandia National Laboratories have developed a high-fidelity virtual model of the human head, neck, and torso to investigate the details of life-threatening injury to the central nervous, respiratory, and cardiovascular systems as a result of blast exposure and behind-armor blunt trauma. This model set is comprised of separate head-neck and torso models that can be used independently or combined to investigate comprehensive injury to life-critical organs as a result of blast, blunt impact, and/or projectile penetration. The Sandia head-neck-torso model represents a 60th percentile human male from the waist up possessing anatomically correct distributions of bone, white and gray brain matter, falx & tentorium membranes, spinal cord, intervertebral disks, cartilage, vasculature, blood, airways, lungs, heart, liver, stomach, kidneys, spleen, muscle, and fat/skin.

42 ENGINEERING↗

Analysis of Mass Averaged Tissue Doses in CAM, CAF, MAX, and FAX

To estimate astronaut health risk due to space radiation, one must have the ability to calculate exposure-related quantities averaged over specific organs and tissue types. In this study, we first examine the anatomical properties of the Computerized Anatomical Man (CAM), Computerized Anatomical Female (CAF), Male Adult voXel (MAX), and Female Adult voXel (FAX) models by comparing the masses of various tissues to the reference values specified by the International Commission on Radiological Protection (ICRP). Major discrepancies are found between the CAM and CAF tissue masses and the ICRP reference data for almost all of the tissues. We next examine the distribution of target points used with the deterministic transport code HZETRN to compute mass averaged exposure quantities. A numerical algorithm is used to generate multiple point distributions for many of the effective dose tissues identified in CAM, CAF, MAX, and FAX. It is concluded that the previously published CAM and CAF point distributions were under-sampled and that the set of point distributions presented here should be adequate for future studies involving CAM, CAF, MAX, or FAX. It is concluded that MAX and FAX are more accurate than CAM and CAF for space radiation analyses.

Slaba, Tony C.↗