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At least 199 records · Page 11

WE-AB-202-06: Correlating Lung CT HU with Transformation-Based and Xe-CT Derived Ventilation

Purpose: Regional lung ventilation is useful to reduce radiation-induced function damage during lung cancer radiation therapy. Recently a new direct HU (Hounsfield unit)-based method was proposed to estimate the ventilation potential without image registration. The purpose of this study is to examine if there is a functional dependence between HU values and transformation-based or Xe-CT derived ventilation. Methods: 4DCT images acquired from 13 patients prior to radiation therapy and 4 mechanically ventilated sheep subjects which also have associated Xe-CT images were used for this analysis. Transformation-based ventilation was computed using Jacobian determinant of the transformation field between peak-exhale and peak-inhale 4DCT images. Both transformation and Xe-CT derived ventilation was computed for each HU bin. Color scatter plot and cumulative histogram were used to compare and validate the direct HU-based method. Results: There was little change of the center and shape of the HU histograms between free breathing CT and 4DCT average, with or without smoothing, and between the repeated 4DCT scans. HU of −750 and −630 were found to have the greatest transformation-based ventilation for human and sheep subjects, respectively. Maximum Xe-CT derived ventilation was found to locate at HU of −600 in sheep subjects. The curve between Xe-CT ventilation and HU was noisy for tissue above HU −400, possibly due to less intensity change of Xe gas during wash-out and wash-in phases. Conclusion: Both transformation-based and Xe-CT ventilation demonstrated that lung tissues with HU values in the range of (-750, −600) HU have the maximum ventilation potential. The correlation between HU and ventilation suggests that HU might be used to help guide the ventilation calculation and make it more robust to noise and image registration errors. Research support from NIH grants CA166703 and CA166119 and a gift from Roger Koch.

60 APPLIED LIFE SCIENCES↗

TH-AB-202-03: A Novel Tool for Computing Deliverable Doses in Dynamic MLC Tracking Treatments

Purpose: In tracked dynamic multi-leaf collimator (MLC) treatments, segments are continuously adapted to the target centroid motion in beams-eye-view. On-the-fly segment adaptation, however, potentially induces dosimetric errors due to the finite MLC leaf width and non-rigid target motion. In this study, we outline a novel tool for computing the 4d dose of lung SBRT plans delivered with MLC tracking. Methods: The following automated workflow was developed: A) centroid tracking, where the initial segments are morphed to each 4dCT phase based on the beams-eye-view GTV shift (followed by a dose calculation on each phase); B) re-optimized tracking, in which all morphed initial plans from (A) are further optimised (“warm-started”) in each 4dCT phase using the initial optimisation parameters but phase-specific volume definitions. Finally, both dose sets are accumulated to the reference phase using deformable image registration. Initial plans were generated according to the RTOG-1021 guideline (54Gy, 3-Fx, equidistant 9-beam IMRT) on the peak-exhale (reference) phase of a phase-binned 4dCT. Treatment planning and delivery simulations were performed in RayStation (research v4.6) using our in-house segment-morphing algorithm, which directly links to RayStation through a native C++ interface. Results: Computing the tracking plans and 4d dose distributions via the in-house interface takes 5 and 8 minutes respectively for centroid and re-optimized tracking. For a sample lung SBRT patient with 14mm peak-to-peak motion in sup-inf direction, mainly perpendicular leaf motion (0-collimator) resulted in small dose changes for PTV-D95 (−13cGy) and GTV-D98 (+18cGy) for the centroid tracking case compared to the initial plan. Modest reductions of OAR doses (e.g. spinal cord D2: −11cGy) were achieved in the idealized tracking case. Conclusion: This study presents an automated “1-click” workflow for computing deliverable MLC tracking doses in RayStation. Adding a non-deliverable re-optimized tracking scenario is expected to help quantify plan robustness for more challenging patients with anatomy deformations. We acknowledge support of the MLC tracking research from Elekta AB. MFF is supported by Cancer Research UK under Programme C33589/A19908. Research at ICR is also supported by Cancer Research UK under Programme C33589/A19727 and NHS funding to the NIHR Biomedical Research Centre at RMH and ICR.

60 APPLIED LIFE SCIENCES↗

TH-CD-209-07: Preliminary Experimental Comparison of Spot- and Continuous Line Scanning with Or Without Rescanning for Gated Proton Therapy

Purpose: We aim to compare the performance of discrete spot- or continuous line scanning combined with rescanning in mitigating residual organ motion during gated proton therapy treatments. Methods: The Quasar respiratory phantom was used to move a 2D scintillation detector on a linear trajectory with sinusoidal motion pattern (sin{sup 4}), 20 mm peak-to-peak amplitude and 5 sec period. Its motion was monitored using a customized solution based on optical tracking technology. We compared spot and line scanning plans for a monoenergetic 150 MeV circular field, 50.4 mm radius at isocenter. Transverse dose distributions at 13 cm depth in PMMA (15.47 mm water equivalent) were measured to compare three options for motion mitigation: rescanning (10× factor), gating and their combination. The gating window was centered in the trajectory plateau to simulate end-exhale gated treatment in presence of 2 mm and 4 mm residual motion, parallel or perpendicular to the primary scanning direction. Results: When the target moves perpendicular to the primary scanning direction, large dose deviations are measured (γ3%/3mm=47%) without mitigation techniques. Beam gating combined with rescanning restores target coverage (γ3%/3mm=91%). For parallel target motion, observed dose distortions in the non-compensated irradiation are smaller (γ3%/3mm=77%). Beam gating alone recovers the 100% gamma pass-rate at 3%/3mm. Continuous line scanning reduces delivery time by up to 60% with respect to discrete spot scanning in presence of motion mitigation, and improves homogeneity when rescanning is applied (up to 20%, perpendicular motion, 4 mm residual motion). Conclusion: The direction of motion has a large impact on the target dose coverage. Nevertheless, even in the worst case scenario, gating combined with rescanning could mitigate the impact of motion on dose deposition. Moreover, continuous line rescanning improves the robustness against residual motion in the gating window. This study has received funding from the European Community’s Seventh Framework Programme (FP7/2007–2013) under grant agreement n.290605 (PSI-FELLOW/COFUND) and ‘Giuliana and Giorgio Stefanini Foundation’.

60 APPLIED LIFE SCIENCES↗

TH-CD-209-08: Quantification of the Interplay Effect in Proton Pencil Beam Scanning Treatment of Lung

Purpose: To quantify the dose degradation caused by the interplay effect based on a beam specific motion analysis in proton pencil beam scanning (PBS) treatment of lung tumors Methods: PBS plans were optimized on average CT using a beam-specific PTV method for 10 consecutive patients with locally advanced non-small-cell-lung-cancer (NSCLC) treated with proton therapy to 6660/180 cGy. End inhalation (CT0) and end exhalation (CT50) were selected as the two extreme scenarios to acquire the relative stopping power ratio difference (Δrsp) for a respiration cycle. The water equivalent difference (ΔWET) per radiological path was calculated from the surface of patient to the iCTV by integrating the Δrsp of each voxel. The motion magnitude of each voxel within the target follows a quasi-Gaussian distribution. A motion index (MI (>5mm WET)), defined as the percentage of target voxels with an absolute integral ΔWET larger than 5 mm, was adopted as a metric to characterize interplay. To simulate the treatment process, 4D dose was calculated by accumulating the spot dose on the corresponding respiration phase to the reference phase CT50 by deformable image registration based on spot timing and patient breathing phase. Results: The study indicated that the magnitude of target underdose in a single fraction plan is proportional to the MI (p<0.001), with larger motion equating to greater dose degradation and standard deviations. The target homogeneity, minimum, maximum and mean dose in the 4D dose accumulations of 37 fractions varied as a function of MI. Conclusion: The MI quantification metric can predict the level of dose degradation in PBS lung cancer treatment, which potentially serves as a clinical decision tool to assess whether patients are suitable to receive PBS treatment.

60 APPLIED LIFE SCIENCES↗

Comparative Assessment of Severe Acute Respiratory Syndrome Coronavirus 2 Variants in the Ferret Model

The continued spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in humans necessitates evaluation of variants for enhanced virulence and transmission. We used the ferret model to perform a comparative analysis of four SARS-CoV-2 strains, including an early pandemic isolate from the United States (WA1), and representatives of the Alpha, Beta, and Delta lineages. While Beta virus was not capable of pronounced replication in ferrets, WA1, Alpha, and Delta viruses productively replicated in the ferret upper respiratory tract, despite causing only mild disease with no overt histopathological changes. Strain-specific transmissibility was observed; WA1 and Delta viruses transmitted in a direct contact setting, whereas Delta virus was also capable of limited airborne transmission. Viral RNA was shed in exhaled air particles from all inoculated animals but was highest for Delta virus. Prior infection with SARS-CoV-2 offered varied protection against reinfection with either homologous or heterologous variants. Notable genomic variants in the spike protein were most frequently detected following WA1 and Delta virus infection.

59 BASIC BIOLOGICAL SCIENCES↗

220 Rn (Thoron) Geohazard in Room Air of Earthen Dwellings in Vietnam

Thoron’s ( 220 Rn) contribution to α -radiation exposure is usually considered negligible compared to that of 222 Rn (radon). Despite its short half-life of 55.6 seconds, thoron can be exhaled from porous surface layers of building materials into indoor air where people subsequently inhale radioisotopes, including metallic radioactive progeny. Bare surfaces of dry porous soil with relatively high 232 Th content can pose a thoron radiation hazard in indoor air. On northern Vietnam’s Dong Van karst plateau, the spatial distribution of thoron was determined in indoor air of traditional earthen and other types of dwellings using portable RAD7 and SARAD® RTM 2200 detectors. “Mud houses” are constructed with local compacted soil and typically do not have any floor or wall coverings (i.e., no plaster, wallpaper, or paint). Detailed measurements in a mud house revealed levels of thoron in room air averaging >500 Bq m -3 . The spatial distribution of α -radiation from thoron in indoor air at a distance of about 1 m from interior walls was fairly homogeneous and averaged ~200 Bq m -3 . Most concerning, from a human health perspective, were the high thoron concentrations of up to 884 Bq m -3 in sleeping areas near mud walls. The average annual thoron radiation dose to inhabitants of mud houses was estimated based on 13 hours of daily occupancy, including daily activities and sleeping. The estimated average thoron inhalation dose of 27.1 mSv a -1 during sleeping hours near mud surfaces accounts for nearly 75% of the total estimated radon and thoron inhalation dose of 37.4 mSv a -1 from indoor mud house air. Our conservative annual radiation dose estimates do not include subsequent radiation from inhaled metallic progeny of thoron. Our data demonstrate a significant human health risk from radiation exposure and a critical need for remediation in traditional northern Vietnamese mud house dwellings.

58 GEOSCIENCES↗

Pathogen Management Kit (Technical Bulletin)

Sandia National Laboratories (SNL) has developed and produced a simple add-on kit (Pathogen Management Kit, or PMK) that can quickly add on to ventilators of all types to disinfect exhaled air to keep healthcare workers safe.

42 ENGINEERING↗

Monte Carlo Simulation and Reconstruction: Assessment of Myocardial Perfusion Imaging of Tracer Dynamics With Cardiac Motion Due to Deformation and Respiration Using Gamma Camera With Continuous Acquisition

Purpose: Myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) is routinely used for stress testing in nuclear medicine. Recently, our group extended its potential going from 3D visual qualitative image analysis to 4D spatiotemporal reconstruction of dynamically acquired data to capture the time variation of the radiotracer concentration and the estimated myocardial blood flow (MBF) and coronary flow reserve (CFR). However, the quality of reconstructed image is compromised due to cardiac deformation and respiration. The work presented here develops an algorithm that reconstructs the dynamic sequence of separate respiratory and cardiac phases and evaluates the algorithm with data simulated with a Monte Carlo simulation for the continuous image acquisition and processing with a slowly rotating SPECT camera. Methods: A clinically realistic Monte Carlo (MC) simulation is developed using the 4D Extended Cardiac Torso (XCAT) digital phantom with respiratory and cardiac motion to model continuous data acquisition of dynamic cardiac SPECT with slowly rotating gamma cameras by incorporating deformation and displacement of the myocardium due to cardiac and respiratory motion. We extended our previously developed 4D maximum-likelihood expectation-maximization (MLEM) reconstruction algorithm for a data set binned from a continuous list mode (LM) simulation with cardiac and respiratory information. Our spatiotemporal image reconstruction uses splines to explicitly model the temporal change of the tracer for each cardiac and respiratory gate that delineates the myocardial spatial position as the tracer washes in and out. Unlike in a fully list-mode data acquisition and reconstruction the accumulated photons are binned over a specific but very short time interval corresponding to each cardiac and respiratory gate. Reconstruction results are presented showing the dynamics of the tracer in the myocardium as it continuously deforms. These results are then compared with the conventional 4D spatiotemporal reconstruction method that models only the temporal changes of the tracer activity. Mean Stabilized Activity (MSA), signal to noise ratio (SNR) and Bias for the myocardium activities for three different target-to-background ratios (TBRs) are evaluated. Dynamic quantitative indices such as wash-in (K1) and wash-out (k2) rates at each gate were also estimated. Results: The MSA and SNR are higher with higher TBRs while biases were improved with higher TBRs to less than 10%. The correlation between exhalation-inhalation sequence with the ground truth during respiratory cycle was excellent. Our reconstruction method showed better resolved myocardial walls during diastole to systole as compared to the ungated 4D image. Estimated values of K1 and k2 were also consistent with the ground truth. Conclusion: The continuous image acquisition for dynamic scan using conventional two-head gamma cameras can provide valuable information for MPI. Our study demonstrated the viability of using a continuous image acquisition method on a widely used clinical two-head SPECT system. Our reconstruction method showed better resolved myocardial walls during diastole to systole as compared to the ungated 4D image. Precise implementation of reconstruction algorithms, better segmentation techniques by generating images of different tissue types and background activity would improve the feasibility of the method in real clinical environment.

60 APPLIED LIFE SCIENCES↗

Simulation of radon-222 with the GEOS-Chem global model: Emissions, seasonality, and convective transport

Radon-222 (222Rn) is a short-lived radioactive gas naturally emitted from land surface, and has long been used to assess convective transport in atmospheric models. In this study, we simulate 222Rn using the GEOS-Chem chemical transport model with aims to improve our understanding of 222Rn emissions and surface concentration seasonality, and to characterize convective transport associated with two Goddard Earth Observing System (GEOS) meteorological products, MERRA and GEOS-FP. We evaluate four available 222Rn emission scenarios by comparing model results with surface observations at 51 global surface sites. The default emission scenario in GEOS-Chem yields a moderate agreement with global surface observations (< 70% data within a factor of 2) and a large underestimate of wintertime surface 222Rn concentrations at Northern Hemisphere mid- and high-latitudes due to an oversimplified formulation of 222Rn emission fluxes (1 atom cm-2 s-1 over land with a reduction by a factor of 3 under freezing conditions). We compose a new global 222Rn emission scenario based on Zhang et al. (2011) and show its potential to improve simulated surface 222Rn concentrations and seasonality. The regional components of this emission scenario include spatially and temporally varying emission fluxes derived from previous measurements of soil radium content and soil exhalation models, which are key factors to 222Rn emission flux rates. However, large model underestimates of surface 222Rn concentrations still exist in Asia, suggesting unusually high regional 222Rn emissions. We propose a conservative up-scaling factor of 1.2 for 222Rn emission fluxes in China, as also constrained by the observed deposition fluxes of 210Pb (decay daughter of 222Rn). With this modification, the model shows better agreement with the observations in Europe and North America (>80% data within a factor of 2), and reasonable agreement in Asia (close to 70%). Further constraints on 222Rn emissions would require additional observations of surface 222Rn concentrations and emission fluxes in central U.S., Canada, Africa, and Asia. We also compare and assess convective transport in model simulations driven by MERRA and GEOS-FP using observed 222Rn vertical profiles during northern mid-latitude summertime and from two short-term airborne campaigns. While the simulations with both GEOS products are able to capture the observed vertical gradient of 222Rn concentrations in the lower troposphere (0-4 km), neither correctly represents the level of convective detrainment, resulting in biases in the middle and upper troposphere. Compared to GEOS-FP, MERRA leads to stronger convective transport of 222Rn, which is partially compensated by its weaker large-scale vertical advection, resulting in similar global vertical distributions of 222Rn concentrations between the two simulations.

Zhang, Bo↗

Device induces lungs to maintain known constant pressure

This device requires the use of thoracic muscles to maintain prescribed air pressure in the lungs for brief periods. It consists of a clear plastic hollow cylinder fitted with a mouthpiece, a spring-loaded piston, and a small vent for escaping air when exhalation into the mouthpiece displaces the piston.

Lippitt, M. W.↗

Exposure system for animals Patent

System for continuous monitoring of exhalations, weighing, and cage cleaning for animal exposed to controlled atmosphere for toxic study

Quattrone, P. D.↗

Carbon dioxide concentrator

Passed exhaled air through electrochemical cell containing alkali metal carbonate aqueous solution, and utilizes platinized electrodes causing reaction of oxygen at cathode with water in electrolyte, producing hydroxyl ions which react with carbon dioxide to form carbonate ions.

Williams, C. F.↗

Breathing-metabolic simulator

Breathing-metabolic simulator was developed to be used for evaluation of life support equipment. Apparatus simulates human breathing rate and controls temperature and humidity of exhaled air as well as its chemical composition. All functions are designed to correspond to various degrees of human response.

Bartlett, R. G.↗

Temperature and humidity control of simulated human breath

Subsystem was developed for breathing metabolic simulator which adjusts temperature and humidity of air to levels of human exhaled breath. Temperature-humidity subsystem is described, consisting of aluminum enclosure with 400 watt heat sheet glued to bottom, vertical separators, inlet connection, and check valve.

Bartlett, R. G.↗

Automation of Bosch reaction for CO2 reduction

System for collecting excess carbon dioxide in space cabin is described. System collects carbon dioxide exhaled by human inhabitants and decomposes gas into carbon and water by reaction with hydrogen in presence of catalyst. Diagram of equipment involved in reaction is included.

Holmes, R. F.↗

Breathing metabolic simulator

The development of a breathing metabolic simulator (BMS) is reported. This BMS simulates all of the breathing and metabolic parameters required for complete evaluation and test of life support and resuscitation equipment. It is also useful for calibrating and validating mechanical and gaseous pulmonary function test procedures. Breathing rate, breathing depth, breath velocity contour, oxygen uptake, and carbon dioxide release are all variable over wide ranges simulating conditions from sleep to hard work with respiratory exchange ratios covering the range from hypoventilation. In addition, all of these parameters are remotely controllable to facilitate use of the device in hostile or remote environments. The exhaled breath is also maintained at body temperature and a high humidity. The simulation is accurate to the extent of having a variable functional residual capacity independent of other parameters.

Bartlett, R. G.↗

Influence of facemask design on operational performance

Spirometric measurements of oxygen volume and determination of the amount of argon in exhaled breath are used to analyze facemask design efficiency during treadmill walking tests with subjects carrying plastic hoods filled with argon. Facemask leakage measurements established the better performance of a pneumatic seal type mask in comparison with plain seal type masks.

Griffin, O. G.↗