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At least 253 records · Page 14

High E6 Gene Expression Predicts for Distant Metastasis and Poor Survival in Patients With HPV-Positive Oropharyngeal Squamous Cell Carcinoma

Purpose: Patients with human papillomavirus (HPV)–positive oropharyngeal squamous cell carcinoma (OPSCC) have a favorable prognosis. As a result, de-escalation clinical trials are under way. However, approximately 10% of patients will experience distant recurrence even with standard-of-care treatment. Here, we sought to identify novel biomarkers to better risk-stratify HPV-positive patients with OPSCC. Methods and Materials: Gene expression profiling by RNA sequencing (RNA-seq) and quantitative polymerase chain reaction was performed on HPV-positive OPSCC primary tumor specimens from patients with and without distant metastasis (DM). Results: RNA-seq analysis of 39 HPV-positive OPSCC specimens revealed that patients with DM had 2-fold higher E6 gene expression levels than did patients without DM (P=.029). This observation was confirmed in a validation cohort comprising 93 patients with HPV-positive OPSCC. The mean normalized E6 expression level in the 17 recurring primary specimens was 13 ± 2 compared with 8 ± 1 in the remaining 76 nonrecurring primaries (P=.001). Receiver operating characteristic analysis established an E6 expression level of 7.3 as a cutoff for worse recurrence-free survival (RFS). Patients from this cohort with high E6 gene expression (E6-high) (n=51, 55%) had more cancer-related deaths (23% vs 2%, P<.001) and DM (26% vs 5%, P<.001) than did patients with low E6 gene expression (E6-low) (n=42, 45%). Kaplan-Meier survival analysis revealed that E6-high had worse RFS (95% vs 69%, P=.004) and cancer-specific survival (97% vs 79%, P=.007). E6-high maintained statistical significance in multivariate regression models balancing surgery, chemotherapy, nodal stage, and smoking status. Gene set enrichment analysis demonstrated that tumors with high E6 expression were associated with P53, epidermal growth factor receptor, activating transcription factor-2, and transforming growth factor-β signaling pathways. Conclusion: High E6 gene expression level identifies HPV-positive OPSCC patients with 5-fold greater risk of distant disease recurrence and worse cancer-specific survival. Validation in a multi-institutional prospective clinical trial is required to assess the utility of E6 gene expression as a clinically useful prognostic biomarker.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Positional Effects from σ-Bonded Platinum(II) on Intersystem Crossing Rates in Perylenediimide Complexes: Synthesis, Structures, and Photophysical Properties

In this research, the synthesis and photophysical properties of a series of new chromophores featuring Pt(II) σ-bonded to perylenediimide (PDI) cores are reported. A Pt(PPh 3 ) 2 X (X = Cl, Br) moiety was attached to PDI in either the ortho or the bay position (2- or 1-positions respectively) or a Pt(PPh 3 ) 2 subunit was used to bridge two bay positions (1- and 12-positions) forming a Pt(II) cyclometalate. Through a combination of steady-state and transient absorption and photoluminescence spectroscopy, the excited-state dynamics of these molecules were revealed, indicating that the Pt atom location on the PDI has a substantial impact on observed intersystem crossing (ISC) rates. The ISC time constants for the bay-substituted and cyclometalated PDIs are between 2.67 and 1.29 ns, respectively, determined by the singlet fluorescence decays from the initially populated singlet excited states. In the case of the ortho -substituted PDI, ISC to the triplet state occurs on the ultrafast time scale with a time constant of 345 fs, determined through ultrafast transient absorption spectroscopy. In all examples, the measured PDI-based fluorescence quantum yields quantitatively correlate with the measured ISC rates leaving little doubt that variation in the Pt(II) substitution position(s) markedly influence the resultant photophysics. Electronic structure calculations suggest differing amounts of metal-based contributions in the lowest excited states as a function of substitution position, supporting the trend of the observed ISC rates.

14 SOLAR ENERGY↗

Observed positive vegetation-rainfall feedbacks in the Sahel dominated by a moisture recycling mechanism

Classic, model-based theory of land-atmosphere interactions across the Sahel promote positive vegetation-rainfall feedbacks dominated by surface albedo mechanism. However, neither the proposed positive vegetation-rainfall feedback nor its underlying albedo mechanism has been convincingly demonstrated using observational data. Here, we present observational evidence for the region’s proposed positive vegetation-rainfall feedback on the seasonal to interannual time scale, and find that it is associated with a moisture recycling mechanism, rather than the classic albedo-based mechanism. Positive anomalies of remotely sensed vegetation greenness across the Sahel during the late and post-monsoon periods favor enhanced evapotranspiration, precipitable water, convective activity and rainfall, indicative of amplified moisture recycling. The identified modest low-level cooling and anomalous atmospheric subsidence in response to positive vegetation greenness anomalies are counter to the responses expected through the classic vegetation-albedo feedback mechanism. The observational analysis further reveals enhanced dust emissions in response to diminished Sahel vegetation growth, potentially contributing to the positive vegetation-rainfall feedback.

54 ENVIRONMENTAL SCIENCES↗

LipidOz enables automated elucidation of lipid carbon–carbon double bond positions from ozone-induced dissociation mass spectrometry data

Lipids play essential roles in many biological processes and disease pathology, but unambiguous identification of lipids is complicated by the presence of multiple isomeric species differing by fatty acyl chain length, stereospecifically numbered (sn) position, and position/stereochemistry of double bonds. Conventional liquid chromatography-mass spectrometry (LC-MS/MS) analyses enable the determination of fatty acyl chain lengths (and in some cases sn position) and number of double bonds, but not carbon-carbon double bond positions. Ozone-induced dissociation (OzID) is a gas-phase oxidation reaction that produces characteristic fragments from lipids containing double bonds. OzID can be incorporated into ion mobility spectrometry (IMS)-MS instruments for the structural characterization of lipids, including additional isomer separation and confident assignment of double bond positions. The complexity and repetitive nature of OzID data analysis and lack of software tool support have limited the application of OzID for routine lipidomics studies. Here, we present an open-source Python tool, LipidOz, for the automated determination of lipid double bond positions from OzID-IMS-MS data, which employs a combination of traditional automation and deep learning approaches. Our results demonstrate the ability of LipidOz to robustly assign double bond positions for lipid standard mixtures and complex lipid extracts, enabling practical application of OzID for future lipidomics.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Positioning colloids at the surfaces of cholesteric liquid crystal droplets

We report on the internal configurations of aqueous dispersions of droplets of cholesteric liquid crystals (LCs; 5–50 μm-in-diameter; comprised of 4-cyano-4'-pentylbiphenyl and 4-(1-methylheptyloxycarbonyl)phenyl-4-hexyloxybenzoate) and their influence on the positioning of surface-adsorbed colloids (0.2 or 1 μm-in-diameter polystyrene (PS)). When N = 2D/P was less than 4, where D is the droplet diameter and P is the cholesteric pitch, the droplets adopted a twisted bipolar structure (TBS) and colloids were observed to assume positions at either the poles or equator of the droplets. A statistical analysis of the distribution of locations of the colloids revealed a potential well of depth 2.7 k B T near the equator, a conclusion that was supported by computer simulations performed via the minimization of the Landau–de Gennes free energy (well depth of 7 k B T from simulation). In contrast, for N > 4, a majority of the droplets exhibited a radial spherical structure (RSS) characterized by a pair of closely spaced surface defects (angle of separation with respect to the center of the droplet θ < 5°) connected by a disclination winding to/from the droplet center, which led to the positioning of pairs of colloids with well-defined spacing at these surface defects. The separation of the pairs of surface-adsorbed colloids was colloid size-dependent, ranging from 1.11 ± 0.04 μm for 1 μm-in-diameter colloids to 1.7 ± 0.2 μm for 200 nm-in-diameter colloids. We also observed long-lived metastable configurations in which the two surface point defects were separated by much larger distances (corresponding to populations with angles of θ = 20 ± 10° and 85 ± 10° with respect to the center), and observed these pairs of defects to also position pairs of colloids. A third configuration, the diametrical spherical structure (DSS) was also observed. Consistent with the predictions of computer simulations, we found experimentally that the DSS is indeed composed of disconnected defect rings positioned along the diameter of the droplet. Finally, these results reveal that the rich palette of defects exhibited by confined cholesteric LC systems (equilibrium and metastable) provide the basis of a versatile class of templates that enable the surface positioning of colloids in ways that are not possible with achiral LC droplets.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Experimental validation of the dual positive and negative ion beam acceleration in the plasma propulsion with electronegative gases thruster

The PEGASES (Plasma Propulsion with Electronegative Gases) thruster is a gridded ion thruster, where both positive and negative ions are accelerated to generate thrust. In this way, additional downstream neutralization by electrons is redundant. To achieve this, the thruster accelerates alternately positive and negative ions from an ion-ion plasma where the electron density is three orders of magnitude lower than the ion densities. This paper presents a first experimental study of the alternate acceleration in PEGASES, where SF{sub 6} is used as the working gas. Various electrostatic probes are used to investigate the source plasma potential and the energy, composition, and current of the extracted beams. We show here that the plasma potential control in such system is key parameter defining success of ion extraction and is sensitive to both parasitic electron current paths in the source region and deposition of sulphur containing dielectric films on the grids. In addition, large oscillations in the ion-ion plasma potential are found in the negative ion extraction phase. The oscillation occurs when the primary plasma approaches the grounded parts of the main core via sub-millimetres technological inputs. By controlling and suppressing the various undesired effects, we achieve perfect ion-ion plasma potential control with stable oscillation-free operation in the range of the available acceleration voltages (±350 V). The measured positive and negative ion currents in the beam are about 10 mA for each component at RF power of 100 W and non-optimized extraction system. Two different energy analyzers with and without magnetic electron suppression system are used to measure and compare the negative and positive ion and electron fluxes formed by the thruster. It is found that at alternate ion-ion extraction the positive and negative ion energy peaks are similar in areas and symmetrical in position with +/− ion energy corresponding to the amplitude of the applied acceleration voltage.

43 PARTICLE ACCELERATORS↗

Accuracy of an infrared marker-based patient positioning system (ExacTrac®) for stereotactic body radiotherapy in localizing the planned isocenter using fiducial markers

Stereotactic Body Radiation Therapy (SBRT) requires a controlled immobilization and position monitoring of patient and target. The purpose of this work is to analyze the performance of the imaging system ExacTrac® (ETX) using infrared and fiducial markers. Materials and methods: In order to assure the accuracy of isocenter localization, a Quality Assurance procedure was applied using an infrared marker-based positioning system. Scans were acquired of an inhouse-agar gel and solid water phantom with infrared spheres. In the inner part of the phantom, three reference markers were delineated as reference and one pellet was place internally; which was assigned as the isocenter. The iPlan® RT Dose treatment planning system. Images were exported to the ETX console. Images were acquired with the ETX to check the correctness of the isocenter placement. Adjustments were made in 6D the reference markers were used to fuse the images. Couch shifts were registered. The procedure was repeated for verification purposes. Results: The data recorded of the verifications in translational and rotational movements showed averaged 3D spatial uncertainties of 0.31 ± 0.42 mm respectively 0.82° ± 0.46° in the phantom and the first correction of these uncertainties were of 1.51 ± 1.14 mm respectively and 1.37° ± 0.61°. Conclusions: This study shows a high accuracy and repeatability in positioning the selected isocenter. The ETX-system for verifying the treatment isocenter position has the ability to monitor the tracing position of interest, making it possible to be used for SBRT positioning within uncertainty ≤1mm.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Positive charging of grains in an afterglow plasma is enhanced by ions drifting in an electric field

In a plasma, the polarity of a dust grain's charge is typically negative, but it can reverse and become positive in an afterglow, when the power sustaining the plasma is switched off. This positive charging, which occurs in the afterglow's first few milliseconds, is studied for grains much larger than a few nm. It is hypothesized that the positive charging is enhanced by the presence of a dc electric field, which causes ions to drift through the neutral gas. A larger value of the reduced electric field E/N leads to a larger ion kinetic energy and thus a greater collection of positive charge on a grain. The maximum possible positive charge is attained if the grain's surface potential rises to match the ion kinetic energy, at a time before ions have departed and the grain's charge becomes frozen. Thereafter, when vacuum conditions prevail, the grain will retain its positive residual charge. In an experiment, dust grains were electrically levitated in a capacitively coupled plasma until the power was abruptly turned off. In the afterglow, grains fell faster than expected due to gravity alone, indicating a downward electric force, in the presence of a remaining dc electric field. Acceleration measurements yielded repeatable results for the residual charge's value, which was of the order +10 4 e and increased with E/N, supporting the hypothesis.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

The Effects of Radiation and Emitted Light Transport on the Positional Response of 11 cm × 42.5 cm × 5.5 cm NaI(Tl) Detectors

Experiments were performed with 30 11 cm x 42.5 x cm 5.5 cm NaI(Tl) detectors to better understand their positional response. Spectra were collected using 0.02 to 0.15 MBq point sources of 241 Am, 137 Cs, 60 Co, and 133 Ba positioned on lines parallel and perpendicular to the long axis of the crystal along both the narrow and wide detector faces as well as at different distances from them. A greater density of positions was sampled at the ends of the detector, and repeated measurements were made to examine potential gain drifts during the experiment. Spectroscopic peak counts, spectroscopic pulse heights, and net counts were analyzed. Empirical equations were fit to the aforementioned data for each specific source energy as a function of source position. In addition, a Monte Carlo radiation transport code was used to simulate the expected positionally variable response based solely upon radiation absorption. The simulated radiation transport efficiency functions were compared to the experimental data. The effects of the geometric radiation efficiency, the attenuation and scattering of emitted light within the scintillation crystal, and combined effects such as non-uniformity of the photomultiplier tube photocathode response and crystal irregularities were then distinguished. Functions describing each effect were derived. The results suggest potential new corrections to data obtained with large scintillation detectors as well as a novel approach to partial positional gamma-ray detection with minimal collimation, given that the energy resolution is within reason for particular photopeaks.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Digital tomosynthesis (DTS) for verification of target position in early stage lung cancer patients

Purpose: The ability to verify intrafraction tumor position is clinically useful for hypofractionated treatments. Short arc kV digital tomosynthesis (DTS) could facilitate more frequent target verification. The authors used DTS combined with triangulation to determine the mean temporal position of small-volume lung tumor targets treated with stereotactic radiotherapy. DTS registration results were benchmarked against online clinical localization using registration between free-breathing cone-beam computed tomography (CBCT) and the average intensity projection (AvIP) of the planning 4DCT.Methods: In this retrospective study, 76 sets of kV-projection images from online CBCT scans of 13 patients were used to generate DTS image slices (CB-DTS) with nonclinical research software (DTS Toolkit, Varian Medical Systems). Three-dimensional tumor motion was 1.3–4 mm in six patients and 6.1–25.4 mm in seven patients on 4DCT (significant difference in the mean of the groups, P < 0.01). The 4DCT AvIP was used to digitally reconstruct the Reference-DTS. DTS registration and DTS registration combined with triangulation were investigated. Progressive shortening of total DTS arc lengths from 95° to 35° around 0° gantry position was evaluated for different scenarios: DTS registration using the entire arc; DTS registration plus triangulation using two nonoverlapping arcs; and for 55° and 45° total gantry rotation, DTS registration plus triangulation using two overlapping arcs. Finally, DTS registration plus triangulation performed at eight gantry angles, each separated by 45° was evaluated using full fan kV projection data for one patient with an immobile tumor and five patients with mobile tumors.Results: For DTS registration alone, shortening arc length did not influence accuracy in X- and Y-directions, but in Z-direction, mean deviations from online CBCT localization systematically increased for shorter arc length (P < 0.05). For example, using a 95° arc mean DTS-CBCT difference was 0.8 mm (1 SD = 0.6 mm) and for a 35° arc the mean was 2.4 mm (1 SD = 1.7 mm). DTS plus triangulation using nonoverlapping-arcs increased accuracy in Z-direction for tested arc lengths ≤55° (P < 0.01). Overlapping arcs increased accuracy in Y-direction for tumors with motion >4 mm (P < 0.02) but increased Z-direction accuracy was only observed with 55° total gantry rotation. The 95th percentile deviations with this overlapping technique in X-, Y-, and Z-directions were 1.3, 2.0, and 2.5 mm, respectively. For the five patients with mobile tumors where DTS + triangulation was performed with 45° intervals, the pooled deviation from online CBCT correction showed, for X-, Y-, and Z-directions, mean of 1.1 mm, standard deviations (SD) of 0.9, 1.0, and 0.9 mm, respectively. The mean + 2 SD was <3 mm for each direction.Conclusions: Short-arc DTS verification of time averaged lung tumor position is feasible using free-breathing kV projection data and the AvIP of the 4DCT as a reference. Observed differences between DTS and online CBCT registration with AvIP were ≤3 mm (mean + 2 SD), however, the increased temporal resolution of DTS + triangulation also identified short period deviations from the average target position on the CBCT. Short-arc DTS appears promising for intrafraction tumor position monitoring during stereotactic lung radiotherapy delivered with a rotational technique.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Interfraction variation in lung tumor position with abdominal compression during stereotactic body radiotherapy

Purpose: To assess the effect of abdominal compression on the interfraction variation in tumor position in lung stereotactic body radiotherapy (SBRT) using cone-beam computed tomography (CBCT) in a larger series of patients with large tumor motion amplitude.Methods: Thirty patients with lung tumor motion exceeding 8 mm who underwent SBRT were included in this study. After translational and rotational initial setup error was corrected based on bone anatomy, CBCT images were acquired for each fraction. The residual interfraction variation was defined as the difference between the centroid position of the visualized target in three dimensions derived from CBCT scans and those derived from averaged intensity projection images. The authors compared the magnitude of the interfraction variation in tumor position between patients treated with [n= 16 (76 fractions)] and without [n= 14 (76 fractions)] abdominal compression.Results: The mean ± standard deviation (SD) of the motion amplitude in the longitudinal direction before abdominal compression was 19.9 ± 7.3 (range, 10–40) mm and was significantly (p < 0.01) reduced to 12.4 ± 5.8 (range, 5–30) mm with compression. The greatest variance of the interfraction variation with abdominal compression was observed in the longitudinal direction, with a mean ± SD of 0.79 ± 3.05 mm, compared to −0.60 ± 2.10 mm without abdominal compression. The absolute values of the 95th percentile of the interfraction variation for one side in each direction were 3.97/6.21 mm (posterior/anterior), 4.16/3.76 mm (caudal/cranial), and 2.90/2.32 mm (right/left) without abdominal compression, and 2.14/5.03 mm (posterior/anterior), 3.93/9.23 mm (caudal/cranial), and 2.37/5.45 mm (right/left) with abdominal compression. An absolute interfraction variation greater than 5 mm was observed in six (9.2%) fractions without and 13 (17.1%) fractions with abdominal compression.Conclusions: Abdominal compression was effective for reducing the amplitude of tumor motion. However, in most of the authors’ patients, the use of abdominal compression seemed to increase the interfraction variation in tumor position, despite reducing lung tumor motion. The daily tumor position deviated more systematically from the tumor position in the planning CT scan in the lateral and longitudinal directions in patients treated with abdominal compression compared to those treated without compression. Therefore, target matching is required to correct or minimize the interfraction variation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Source position verification and dosimetry in HDR brachytherapy using an EPID

Purpose: Accurate treatment delivery in high dose rate (HDR) brachytherapy requires correct source dwell positions and dwell times to be administered relative to each other and to the surrounding anatomy. Treatment delivery inaccuracies predominantly occur for two reasons: (i) anatomical movement or (ii) as a result of human errors that are usually related to incorrect implementation of the planned treatment. Electronic portal imaging devices (EPIDs) were originally developed for patient position verification in external beam radiotherapy and their application has been extended to provide dosimetric information. The authors have characterized the response of an EPID for use with an {sup 192}Ir brachytherapy source to demonstrate its use as a verification device, providing both source position and dosimetric information.Methods: Characterization of the EPID response using an {sup 192}Ir brachytherapy source included investigations of reproducibility, linearity with dose rate, photon energy dependence, and charge build-up effects associated with exposure time and image acquisition time. Source position resolution in three dimensions was determined. To illustrate treatment verification, a simple treatment plan was delivered to a phantom and the measured EPID dose distribution compared with the planned dose.Results: The mean absolute source position error in the plane parallel to the EPID, for dwells measured at 50, 100, and 150 mm source to detector distances (SDD), was determined to be 0.26 mm. The resolution of the z coordinate (perpendicular distance from detector plane) is SDD dependent with 95% confidence intervals of ±0.1, ±0.5, and ±2.0 mm at SDDs of 50, 100, and 150 mm, respectively. The response of the EPID is highly linear to dose rate. The EPID exhibits an over-response to low energy incident photons and this nonlinearity is incorporated into the dose calibration procedure. A distance (spectral) dependent dose rate calibration procedure has been developed. The difference between measured and planned dose is less than 2% for 98.0% of pixels in a two-dimensional plane at an SDD of 100 mm.Conclusions: Our application of EPID dosimetry to HDR brachytherapy provides a quality assurance measure of the geometrical distribution of the delivered dose as well as the source positions, which is not possible with any current HDR brachytherapy verification system.

61 RADIATION PROTECTION AND DOSIMETRY↗

TH-C-BRD-03: Determining the Optimal Collimator Position for Collimated Pencil Beam Scanning Proton Therapy

Purpose: There has been a growing interest in applying collimation to pencil beam scanning (PBS) proton therapy in order to sharpen the lateral dose falloff out of the target, especially at low energies. Currently, there is not a method to optimally determine the collimation position or margin around the target. A uniform margin would not be ideal due to the fact that an incoming symmetric pencil beam, after being intercepted by a collimator near the target boundary, will become asymmetric and experience a lateral shift away from its original spot location, leaving the target insufficiently covered. We demonstrate a method that optimally determines the collimator position on a per-spot basis, in order to maximize target dose while minimizing normal tissue dose. Methods: A library of collimated pencil beams were obtained through Monte Carlo simulation with a collimator placed at varying distances from the central axis of an incoming symmetrical pencil beam of 118 MeV and 5 mm sigma-in-air. Two-dimensional treatment plans were then created using this library of collimated pencil beams. For each spot position in a treatment plan, the collimator position was optimally determined in such a way that the resultant pencil beam maximized the ratio of in-target dose and out-of-target dose. For comparison, un-collimated treatment plans were also computed. Results: The spot-by-spot optimally determined collimator positions allowed the reduction of normal tissue dose while maintaining the same target coverage as un-collimated PBS. Quantitatively, the mean dose outside of the target was reduced by approximately 40% as compared to the plan without collimation. Conclusion: The proposed method determines the optimal collimator position for each spot in collimated PBS proton therapy. The use of a collimator will improve PBS dose distributions achievable today and will continue to be the subject of future investigations.

07 ISOTOPE AND RADIATION SOURCES↗

Poster — Thur Eve — 23: Dose and Position Quality Assurance using the RADPOS System for 4D Radiotherapy with CyberKnife

Introduction: RADPOS 4D dosimetry system consists of a microMOSFET dosimeter combined with an electromagnetic positioning sensor, which allows for performing real-time dose and position measurements simultaneously. In this report the use of RADPOS as an independent quality assurance (QA) tool during CyberKnife 4D radiotherapy treatment is described. In addition to RADPOS, GAFCHROMIC® films were used for simultaneous dose measurement. Methods: RADPOS and films were calibrated in a Solid Water® phantom at 1.5 cm depth, SAD= 80 cm, using 60 mm cone. CT based treatment plan was created for a Solid Water® breast phantom containing metal fiducials and RADPOS probe. Dose calculations were performed using iPlan pencil beam algorithm. Before the treatment delivery, GAFCHROMIC® film was inserted inside the breast phantom, next to the RADPOS probe. Then the phantom was positioned on the chest platform of the QUASAR, to which Synchrony LED optical markers were also attached. Position logging began for RADPOS and the Synchrony tracking system, the QUASAR motion was initiated and the treatment was delivered. Results: RADPOS position measurements very closely matched the LED marker positions recorded by the Synchrony camera tracking system. The RADPOS measured dose was 2.5% higher than the average film measured dose, which is within the experimental uncertainties. Treatment plan calculated dose was 4.1 and 1.6% lower than measured by RADPOS and film, respectively. This is most likely due to the inferior nature of the dose calculation algorithm. Conclusions: Our study demonstrates that RADPOS system is a useful tool for independent QA of CyberKnife treatments.

07 ISOTOPE AND RADIATION SOURCES↗

Sci—Thur PM: Imaging — 01: Position-sensitive noise characteristics in multi-pinhole cardiac SPECT imaging

Myocardial perfusion imaging (MPI) with Single Photon Emission Computed Tomography (SPECT) is invaluable in the diagnosis and management of heart disease. It provides essential information on myocardial blood flow and ischemia. Multi-pinhole dedicated cardiac-SPECT cameras offer improved count sensitivity, and spatial and energy resolutions over parallel-hole camera designs however variable sensitivity across the field-of-view (FOV) can lead to position-dependent noise variations. Since MPI evaluates differences in the signal-to-noise ratio, noise variations in the camera could significantly impact the sensitivity of the test for ischemia. We evaluated the noise characteristics of GE Healthcare's Discovery NM530c camera with a goal of optimizing the accuracy of our patient assessment and thereby improving outcomes. Theoretical sensitivity maps of the camera FOV, including attenuation effects, were estimated analytically based on the distance and angle between the spatial position of a given voxel and each pinhole. The standard deviation in counts, σ was inferred for each voxel position from the square root of the sensitivity mapped at that position. Noise was measured experimentally from repeated (N=16) acquisitions of a uniform spherical Tc-99m-water phantom. The mean (μ) and standard deviation (σ) were calculated for each voxel position in the reconstructed FOV. Noise increased ∼2.1× across a 12 cm sphere. A correlation of 0.53 is seen when experimental noise is compared with theory suggesting that ∼53% of the noise is attributed to the combined effects of attenuation and the multi-pinhole geometry. Further investigations are warranted to determine the clinical impact of the position-dependent noise variation.

60 APPLIED LIFE SCIENCES↗

Patient position alters attenuation effects in multipinhole cardiac SPECT

Purpose: Dedicated cardiac cameras offer improved sensitivity over conventional SPECT cameras. Sensitivity gains are obtained by large numbers of detectors and novel collimator arrangements such as an array of multiple pinholes that focus on the heart. Pinholes lead to variable amounts of attenuation as a source is moved within the camera field of view. This study evaluated the effects of this variable attenuation on myocardial SPECT images. Methods: Computer simulations were performed for a set of nine point sources distributed in the left ventricular wall (LV). Sources were placed at the location of the heart in both an anthropomorphic and a water-cylinder computer phantom. Sources were translated in x, y, and z by up to 5 cm from the center. Projections were simulated with and without attenuation and the changes in attenuation were compared. A LV with an inferior wall defect was also simulated in both phantoms over the same range of positions. Real camera data were acquired on a Discovery NM530c camera (GE Healthcare, Haifa, Israel) for five min in list-mode using an anthropomorphic phantom (DataSpectrum, Durham, NC) with 100 MBq of Tc-99m in the LV. Images were taken over the same range of positions as the simulations and were compared based on the summed perfusion score (SPS), defect width, and apparent defect uptake for each position. Results: Point sources in the water phantom showed absolute changes in attenuation of ≤8% over the range of positions and relative changes of ≤5% compared to the apex. In the anthropomorphic computer simulations, absolute change increased to 20%. The changes in relative attenuation caused a change in SPS of <1.5 for the water phantom but up to 4.2 in the anthropomorphic phantom. Changes were larger for axial than for transverse translations. These results were supported by SPS changes of up to six seen in the physical anthropomorphic phantom for axial translations. Defect width was also seen to significantly increase. The position-dependent changes were removed with attenuation correction. Conclusions: Translation of a source relative to a multipinhole camera caused only small changes in homogeneous phantoms with SPS changing <1.5. Inhomogeneous attenuating media cause much larger changes to occur when the source is translated. Changes in SPS of up to six were seen in an anthropomorphic phantom for axial translations. Attenuation correction removes the position-dependent changes in attenuation.

60 APPLIED LIFE SCIENCES↗

SU-E-P-36: Evaluation of MLC Positioning Errors in Dynamic IMRT Treatments by Analyzing Dynalog Files

Purpose: To assess the accuracy of MLC positioning in Varian linear accelerator, in dynamic IMRT technique, from the analysis of dynalog files generated by the MLC controller. Methods: In Clinac accelerators (pre-TrueBeam technology), control system has an approximately 50ms delay (one control cycle time). Then, the system compares the measured position to the planned position corresponding to the next control cycle. As it has been confirmed by Varian technical support, this effect causes that measured positions appear in dynalogs one cycle out of phase with respect to the planned positions. Around 9000 dynalogs have been analyzed, coming from the three linear accelerators of our center (one Trilogy and two Clinac 21EX) equipped with a Millennium 120 MLC. In order to compare our results to recent publications, leaf positioning errors (RMS and 95th percentile) are calculated with and without delay effect. Dynalogs have been analyzed using a in-house Matlab software. Results: The RMS errors were 0.341, 0.339 and 0.348mm for each Linac; being the average error 0.343 mm. The 95th percentiles of the error were 0.617, 0.607 and 0.625; with an average of 0.617mm. A recent multi-institution study carried out by Kerns et al. found a mean leaf RMS error of 0.32mm and a 95th percentile error value of 0.64mm.Without delay effect, mean leaf RMS errors obtained were 0.040, 0.042 and 0.038mm for each treatment machine; being the average 0.040mm. The 95th percentile error values obtained were 0.057, 0.058 and 0.054 mm, with an average of 0.056mm. Conclusion: Results obtained for the mean leaf RMS error and the mean 95th percentile were consistent with the multi-institution study. Calculated error statistics with delay effect are significantly larger due to the speed proportional and systematic leaf offset. Consequently it is proposed to correct this effect in dynalogs analysis to determine the MLC performance.

60 APPLIED LIFE SCIENCES↗

Using the Charge-Discharge Cycling of Positive Electrode Symmetric Cells to Find Electrolyte/Electrode Combinations with Minimum Reactivity

The effects of solvents, salts, electrolyte additives and surface coatings on LiNi 0.4 Mn 0.4 Co 0.2 O 2 (NMC442) or LiNi 0.6 Mn 0.2 Co 0.2 O 2 (NMC622) have been probed using positive electrode Li-ion symmetric cells coupled with dV/dQ analysis. A robust symmetric cell design is presented which prevents hardware corrosion for over at least 800 hours of testing to 4.5 V vs. Li/Li + at 40°C. Positive electrode symmetric cells using uncoated positive electrode materials and 1M LiPF 6 EC:EMC 3:7 or 1M LiPF 6 EMC electrolyte rapidly developed high impedance and showed poor capacity retention. However, if 1% pyridine boron trifluoride (PBF) was added to these electrolytes, cell performance was dramatically improved. Replacing LiPF 6 by LiBF 4 in the electrolytes above, with or without PBF, yielded positive electrode symmetric cells with good capacity retention. Two types of surface coatings were explored on NMC622 positive electrodes. Cells using surface-coated positive electrodes demonstrated better capacity retention for all electrolytes compared to cells without surface coatings. Finally, this work can be used as a guide by those attempting to find electrolyte/electrode pairs suitable for use in NMC/graphite cells that can operate with long lifetime to 4.5 V.

25 ENERGY STORAGE↗