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DOE OSTI2012

Functionality and operation of fluoroscopic automatic brightness control/automatic dose rate control logic in modern cardiovascular and interventional angiography systems: A Report of Task Group 125 Radiography/Fluoroscopy Subcommittee, Imaging Physics Committee, Science Council

Task Group 125 (TG 125) was charged with investigating the functionality of fluoroscopic automatic dose rate and image quality control logic in modern angiographic systems, paying specific attention to the spectral shaping filters and variations in the selected radiologic imaging parameters. The task group was also charged with describing the operational aspects of the imaging equipment for the purpose of assisting the clinical medical physicist with clinical set-up and performance evaluation. Although there are clear distinctions between the fluoroscopic operation of an angiographic system and its acquisition modes (digital cine, digital angiography, digital subtraction angiography, etc.), the scope of this work was limited to the fluoroscopic operation of the systems studied. The use of spectral shaping filters in cardiovascular and interventional angiography equipment has been shown to reduce patient dose. If the imaging control algorithm were programmed to work in conjunction with the selected spectral filter, and if the generator parameters were optimized for the selected filter, then image quality could also be improved. Although assessment of image quality was not included as part of this report, it was recognized that for fluoroscopic imaging the parameters that influence radiation output, differential absorption, and patient dose are also the same parameters that influence image quality. Therefore, this report will utilize the terminology ''automatic dose rate and image quality'' (ADRIQ) when describing the control logic in modern interventional angiographic systems and, where relevant, will describe the influence of controlled parameters on the subsequent image quality. A total of 22 angiography units were investigated by the task group and of these one each was chosen as representative of the equipment manufactured by GE Healthcare, Philips Medical Systems, Shimadzu Medical USA, and Siemens Medical Systems. All equipment, for which measurement data were included in this report, was manufactured within the three year period from 2006 to 2008. Using polymethylmethacrylate (PMMA) plastic to simulate patient attenuation, each angiographic imaging system was evaluated by recording the following parameters: tube potential in units of kilovolts peak (kVp), tube current in units of milliamperes (mA), pulse width (PW) in units of milliseconds (ms), spectral filtration setting, and patient air kerma rate (PAKR) as a function of the attenuator thickness. Data were graphically plotted to reveal the manner in which the ADRIQ control logic responded to changes in object attenuation. There were similarities in the manner in which the ADRIQ control logic operated that allowed the four chosen devices to be divided into two groups, with two of the systems in each group. There were also unique approaches to the ADRIQ control logic that were associated with some of the systems, and these are described in the report. The evaluation revealed relevant information about the testing procedure and also about the manner in which different manufacturers approach the utilization of spectral filtration, pulsed fluoroscopy, and maximum PAKR limitation. This information should be particularly valuable to the clinical medical physicist charged with acceptance testing and performance evaluation of modern angiographic systems.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2012

Image features for misalignment correction in medical flat-detector CT

Purpose: Misalignment artifacts are a serious problem in medical flat-detector computed tomography. Generally, the geometrical parameters, which are essential for reconstruction, are provided by preceding calibration routines. These procedures are time consuming and the later use of stored parameters is sensitive toward external impacts or patient movement. The method of choice in a clinical environment would be a markerless online-calibration procedure that allows flexible scan trajectories and simultaneously corrects misalignment and motion artifacts during the reconstruction process. Therefore, different image features were evaluated according to their capability of quantifying misalignment. Methods: Projections of the FORBILD head and thorax phantoms were simulated. Additionally, acquisitions of a head phantom and patient data were used for evaluation. For the reconstruction different sources and magnitudes of misalignment were introduced in the geometry description. The resulting volumes were analyzed by entropy (based on the gray-level histogram), total variation, Gabor filter texture features, Haralick co-occurrence features, and Tamura texture features. The feature results were compared to the back-projection mismatch of the disturbed geometry. Results: The evaluations demonstrate the ability of several well-established image features to classify misalignment. The authors elaborated the particular suitability of the gray-level histogram-based entropy on identifying misalignment artifacts, after applying an appropriate window level (bone window). Conclusions: Some of the proposed feature extraction algorithms show a strong correlation with the misalignment level. Especially, entropy-based methods showed very good correspondence, with the best of these being the type that uses the gray-level histogram for calculation. This makes it a suitable image feature for online-calibration.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

The Impact of Extent and Location of Mediastinal Lymph Node Involvement on Survival in Stage III Non-Small Cell Lung Cancer Patients Treated With Definitive Radiotherapy

Purpose: Several surgical series have identified subcarinal, contralateral, and multilevel nodal involvement as predictors of poor overall survival in patients with Stage III non-small-cell lung cancer (NSCLC) treated with definitive resection. This retrospective study evaluates the impact of extent and location of mediastinal lymph node (LN) involvement on survival in patients with Stage III NSCLC treated with definitive radiotherapy. Methods and Materials: We analyzed 106 consecutive patients with T1-4 N2-3 Stage III NSCLC treated with definitive radiotherapy at University of Pennsylvania between January 2003 and February 2009. For this analysis, mediastinal LN stations were divided into four mutually exclusive groups: supraclavicular, ipsilateral mediastinum, contralateral mediastinum, and subcarinal. Patients' conditions were then analyzed according to the extent of involvement and location of mediastinal LN stations. Results: The majority (88%) of patients received sequential or concurrent chemotherapy. The median follow-up time for survivors was 32.6 months. By multivariable Cox modeling, chemotherapy use (hazard ratio [HR]: 0.21 [95% confidence interval (CI): 0.07-0.63]) was associated with improved overall survival. Increasing primary tumor [18F]-fluoro-2-deoxy-glucose avidity (HR: 1.11 [CI: 1.06-1.19]), and subcarinal involvement (HR: 2.29 [CI: 1.11-4.73]) were significant negative predictors of overall survival. On univariate analysis, contralateral nodal involvement (HR: 0.70 [CI: 0.33-1.47]), supraclavicular nodal involvement (HR: 0.78 [CI: 0.38-1.67]), multilevel nodal involvement (HR: 0.97 [CI: 0.58-1.61]), and tumor size (HR: 1.04 [CI: 0.94-1.14]) did not predict for overall survival. Patients with subcarinal involvement also had lower rates of 2-year nodal control (51.2% vs. 74.9%, p = 0.047) and 2-year distant control (28.4% vs. 61.2%, p = 0.043). Conclusions: These data suggest that the factors that determine oncologic outcome in Stage III NSCLC patients treated with definitive radiotherapy are distinct from those observed in patients who undergo surgical resection. The ultimate efficacy of radiation in locally advanced NSCLC is dependent on the intrinsic biology of the tumor.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Simulation of dose distribution for iridium-192 brachytherapy source type-H01 using MCNPX

Dosimetric data for a brachytherapy source should be known before it used for clinical treatment. Iridium-192 source type H01 was manufactured by PRR-BATAN aimed to brachytherapy is not yet known its dosimetric data. Radial dose function and anisotropic dose distribution are some primary keys in brachytherapy source. Dose distribution for Iridium-192 source type H01 was obtained from the dose calculation formalism recommended in the AAPM TG-43U1 report using MCNPX 2.6.0 Monte Carlo simulation code. To know the effect of cavity on Iridium-192 type H01 caused by manufacturing process, also calculated on Iridium-192 type H01 if without cavity. The result of calculation of radial dose function and anisotropic dose distribution for Iridium-192 source type H01 were compared with another model of Iridium-192 source.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Monte Carlo investigation of I-125 interseed attenuation for standard and thinner seeds in prostate brachytherapy with phantom validation using a MOSFET

Purpose: In permanent seed implant prostate brachytherapy the actual dose delivered to the patient may be less than that calculated by TG-43U1 due to interseed attenuation (ISA) and differences between prostate tissue composition and water. In this study the magnitude of the ISA effect is assessed in a phantom and in clinical prostate postimplant cases. Results are compared for seed models 6711 and 9011 with 0.8 and 0.5 mm diameters, respectively. Methods: A polymethyl methacrylate (PMMA) phantom was designed to perform ISA measurements in a simple eight-seed arrangement and at the center of an implant of 36 seeds. Monte Carlo (MC) simulation and experimental measurements using a MOSFET dosimeter were used to measure dose rate and the ISA effect. MC simulations of 15 CT-based postimplant prostate treatment plans were performed to compare the clinical impact of ISA on dose to prostate, urethra, rectum, and the volume enclosed by the 100% isodose, for 6711 and 9011 seed models. Results: In the phantom, ISA reduced the dose rate at the MOSFET position by 8.6%-18.3% (6711) and 7.8%-16.7% (9011) depending on the measurement configuration. MOSFET measured dose rates agreed with MC simulation predictions within the MOSFET measurement uncertainty, which ranged from 5.5% to 7.2% depending on the measurement configuration (k= 1, for the mean of four measurements). For 15 clinical implants, the mean ISA effect for 6711 was to reduce prostate D90 by 4.2 Gy (3%), prostate V100 by 0.5 cc (1.4%), urethra D10 by 11.3 Gy (4.4%), rectal D2cc by 5.5 Gy (4.6%), and the 100% isodose volume by 2.3 cc. For the 9011 seed the mean ISA effect reduced prostate D90 by 2.2 Gy (1.6%), prostate V100 by 0.3 cc (0.7%), urethra D10 by 8.0 Gy (3.2%), rectal D2cc by 3.1 Gy (2.7%), and the 100% isodose volume by 1.2 cc. Differences between the MC simulation and TG-43U1 consensus data for the 6711 seed model had a similar impact, reducing mean prostate D90 by 6 Gy (4.2%) and V100 by 0.6 cc (1.8%). Conclusions: ISA causes the delivered dose in prostate seed implant brachytherapy to be lower than the dose calculated by TG-43U1. MC simulation of phantom seed arrangements show that dose at a point can be reduced by up to 18% and this has been validated using a MOSFET dosimeter. Clinical simulations show that ISA reduces DVH parameter values, but the reduction is less for thinner seeds.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

Spatial and dose–response analysis of fibrotic lung changes after stereotactic body radiation therapy

Purpose: Stereotactic body radiation therapy (SBRT) is becoming the standard of care for early stage nonoperable lung cancers. Accurate dose–response modeling is challenging for SBRT because of the decreased number of clinical toxicity events. As a surrogate for a clinical toxicity endpoint, studies have proposed to use radiographic changes in follow up computed tomography (CT) scans to evaluate lung SBRT normal tissue effects. The purpose of the current study was to use local fibrotic lung regions to spatially and dosimetrically evaluate lung changes in patients that underwent SBRT.Methods: Forty seven SBRT patients treated at our institution from 2003 to 2009 were used for the current study. Our patient cohort had a total of 148 follow up CT scans ranging from 3 to 48 months post-therapy. Post-treatment scans were binned into intervals of 3, 6, 12, 18, 24, 30, and 36 months after the completion of treatment. Deformable image registration was used to align the follow up CT scans with the pretreatment CT and dose distribution. Areas of visible fibrotic changes were contoured. The centroid of each gross tumor volume (GTV) and contoured fibrosis volume was calculated and the fibrosis volume location and movement (magnitude and direction) relative to the GTV and 30 Gy isodose centroid were analyzed. To perform a dose–response analysis, each voxel in the fibrosis volume was sorted into 10 Gy dose bins and the average CT number value for each dose bin was calculated. Dose–response curves were generated by plotting the CT number as a function of dose bin and time posttherapy.Results: Both fibrosis and GTV centroids were concentrated in the upper third of the lung. The average radial movement of fibrosis centroids relative to the GTV centroids was 2.6 cm with movement greater than 5 cm occurring in 11% of patients. Evaluating dose–response curves revealed an overall trend of increasing CT number as a function of dose. The authors observed a CT number plateau at doses ranging from 30 to 50 Gy for the 3, 6, and 12 months posttherapy time points. There was no evident plateau for the dose–response curves generated using data from the 18, 24, 30, and 36 months posttherapy time points.Conclusions: Regions of local fibrotic lung changes in patients that underwent SBRT were evaluated spatially and dosimetrically. The authors found that the average fibrosis movement was 2.6 cm with movement greater than 5 cm possible. Evaluating dose–response curves revealed an overall trend of increasing CT number as a function of dose. Furthermore, our dose–response data also suggest that one of the possible explanations of the CT number plateau effect may be the time posttherapy of the acquired data. Understanding normal tissue dose–response is important for reducing toxicity after SBRT, especially in cases where larger tumors are treated. The methods presented in the current work build on prior quantitative studies and further enhance the understanding of normal lung dose–response after SBRT.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2012

A dose point kernel database using GATE Monte Carlo simulation toolkit for nuclear medicine applications: Comparison with other Monte Carlo codes

Purpose: GATE is a Monte Carlo simulation toolkit based on the Geant4 package, widely used for many medical physics applications, including SPECT and PET image simulation and more recently CT image simulation and patient dosimetry. The purpose of the current study was to calculate dose point kernels (DPKs) using GATE, compare them against reference data, and finally produce a complete dataset of the total DPKs for the most commonly used radionuclides in nuclear medicine. Methods: Patient-specific absorbed dose calculations can be carried out using Monte Carlo simulations. The latest version of GATE extends its applications to Radiotherapy and Dosimetry. Comparison of the proposed method for the generation of DPKs was performed for (a) monoenergetic electron sources, with energies ranging from 10 keV to 10 MeV, (b) beta emitting isotopes, e.g., {sup 177}Lu, {sup 90}Y, and {sup 32}P, and (c) gamma emitting isotopes, e.g., {sup 111}In, {sup 131}I, {sup 125}I, and {sup 99m}Tc. Point isotropic sources were simulated at the center of a sphere phantom, and the absorbed dose was stored in concentric spherical shells around the source. Evaluation was performed with already published studies for different Monte Carlo codes namely MCNP, EGS, FLUKA, ETRAN, GEPTS, and PENELOPE. A complete dataset of total DPKs was generated for water (equivalent to soft tissue), bone, and lung. This dataset takes into account all the major components of radiation interactions for the selected isotopes, including the absorbed dose from emitted electrons, photons, and all secondary particles generated from the electromagnetic interactions. Results: GATE comparison provided reliable results in all cases (monoenergetic electrons, beta emitting isotopes, and photon emitting isotopes). The observed differences between GATE and other codes are less than 10% and comparable to the discrepancies observed among other packages. The produced DPKs are in very good agreement with the already published data, which allowed us to produce a unique DPKs dataset using GATE. The dataset contains the total DPKs for {sup 67}Ga, {sup 68}Ga, {sup 90}Y, {sup 99m}Tc, {sup 111}In, {sup 123}I, {sup 124}I, {sup 125}I, {sup 131}I, {sup 153}Sm, {sup 177}Lu {sup 186}Re, and {sup 188}Re generated in water, bone, and lung. Conclusions: In this study, the authors have checked GATE's reliability for absorbed dose calculation when transporting different kind of particles, which indicates its robustness for dosimetry applications. A novel dataset of DPKs is provided, which can be applied in patient-specific dosimetry using analytical point kernel convolution algorithms.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

The effect of voxel size on dose distribution in Varian Clinac iX 6 MV photon beam using Monte Carlo simulation

Recently, Monte Carlo (MC) calculation method has reported as the most accurate method of predicting dose distributions in radiotherapy. The MC code system (especially DOSXYZnrc) has been used to investigate the different voxel (volume elements) sizes effect on the accuracy of dose distributions. To investigate this effect on dosimetry parameters, calculations were made with three different voxel sizes. The effects were investigated with dose distribution calculations for seven voxel sizes: 1 × 1 × 0.1 cm{sup 3}, 1 × 1 × 0.5 cm{sup 3}, and 1 × 1 × 0.8 cm{sup 3}. The 1 × 10{sup 9} histories were simulated in order to get statistical uncertainties of 2%. This simulation takes about 9-10 hours to complete. Measurements are made with field sizes 10 × 10 cm2 for the 6 MV photon beams with Gaussian intensity distribution FWHM 0.1 cm and SSD 100.1 cm. MC simulated and measured dose distributions in a water phantom. The output of this simulation i.e. the percent depth dose and dose profile in d{sub max} from the three sets of calculations are presented and comparisons are made with the experiment data from TTSH (Tan Tock Seng Hospital, Singapore) in 0-5 cm depth. Dose that scored in voxels is a volume averaged estimate of the dose at the center of a voxel. The results in this study show that the difference between Monte Carlo simulation and experiment data depend on the voxel size both for percent depth dose (PDD) and profile dose. PDD scan on Z axis (depth) of water phantom, the big difference obtain in the voxel size 1 × 1 × 0.8 cm{sup 3} about 17%. In this study, the profile dose focused on high gradient dose area. Profile dose scan on Y axis and the big difference get in the voxel size 1 × 1 × 0.1 cm{sup 3} about 12%. This study demonstrated that the arrange voxel in Monte Carlo simulation becomes important.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2011

Dosimetric Comparison of Involved-Field Three-Dimensional Conformal Photon Radiotherapy and Breast-Sparing Proton Therapy for the Treatment of Hodgkin's Lymphoma in Female Pediatric Patients

Purpose: To assess the potential reduction in breast dose for young girls with Hodgkin's lymphoma (HL) treated with breast-sparing proton therapy (BS-PT) as compared with three-dimensional conformal involved-field photon radiotherapy (3D-CRT). Methods and Materials: The Clarian Health Cancer Registry was queried for female pediatric patients with the diagnosis of HL who received radiotherapy at the Indiana University Simon Cancer Center during 2006-2009. The original CT simulation images were obtained, and 3D-CRT and BS-PT plans delivering 21 Gy or cobalt gray equivalent (CGE) in 14 fractions were created for each patient. Dose-volume histogram data were collected for both 3D-CRT and BS-PT plans and compared by paired t test for correlated samples. Results: The cancer registry provided 10 female patients with Ann Arbor Stage II HL, aged 10-18 years at the time of treatment. Both mean and maximum breast dose were significantly less with BS-PT compared with 3D-CRT: 0.95 CGE vs. 4.70 Gy (p < 0.001) and 21.07 CGE vs. 23.11 Gy (p < 0.001), respectively. The volume of breast receiving 1.0 Gy/CGE and 5.0 Gy/CGE was also significantly less with BS-PT, 194 cm{sup 3} and 93 cm{sup 3}, respectively, compared with 790 cm{sup 3} and 360 cm{sup 3} with 3D-CRT (p = 0.009, 0.013). Conclusion: Breast-sparing proton therapy has the potential to reduce unnecessary breast dose in young girls with HL by as much as 80% relative to involved-field 3D-CRT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-E-T-673: Recent Developments and Comprehensive Validations of a GPU-Based Proton Monte Carlo Simulation Package, GPMC

Purpose: A GPU-based Monte Carlo (MC) simulation package gPMC has been previously developed and high computational efficiency was achieved. This abstract reports our recent improvements on this package in terms of accuracy, functionality, and code portability. Methods: In the latest version of gPMC, nuclear interaction cross section database was updated to include data from TOPAS/Geant4. Inelastic interaction model, particularly the proton scattering angle distribution, was updated to improve overall simulation accuracy. Calculation of dose averaged LET (LETd) was implemented. gPMC was ported onto an OpenCL environment to enable portability across different computing devices (GPUs from different vendors and CPUs). We also performed comprehensive tests of the code accuracy. Dose from electro-magnetic (EM) interaction channel, primary and secondary proton doses and fluences were scored and compared with those computed by TOPAS. Results: In a homogeneous water phantom with 100 and 200 MeV beams, mean dose differences in EM channel computed by gPMC and by TOPAS were 0.28% and 0.65% of the corresponding maximum dose, respectively. With the Geant4 nuclear interaction cross section data, mean difference of primary proton dose was 0.84% for the 200 MeV case and 0.78% for the 100 MeV case. After updating inelastic interaction model, maximum difference of secondary proton fluence and dose were 0.08% and 0.5% for the 200 MeV beam, and 0.04% and 0.2% for the 100 MeV beam. In a test case with a 150MeV proton beam, the mean difference between LETd computed by gPMC and TOPAS was 0.96% within the proton range. With the OpenCL implementation, gPMC is executable on AMD and Nvidia GPUs, as well as on Intel CPU in single or multiple threads. Results on different platforms agreed within statistical uncertainty. Conclusion: Several improvements have been implemented in the latest version of gPMC, which enhanced its accuracy, functionality, and code portability.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

MCNP 2020: Preparing LANL Monte Carlo for Exascale Computer Systems (White Paper)

The MCNP Monte Carlo code for simulating particle transport is the product of over 60 years of Monte Carlo code development at LANL. MCNP is the most-used code worldwide for particle transport in nuclear systems, with over 10,000 users in dozens of application areas. At LANL, MCNP is used extensively in applications for nuclear criticality safety, stockpile stewardship, homeland security, radiological safety, experiment design and analysis, etc., and is considered a critical technology resource for national defense. MCNP is often referred to as the “gold standard” for radiation transport calculations, based on the long development history and extensive validation work. Today, however, this critical technology and its well-deserved reputation are at risk. We propose a targeted effort over the next several years to upgrade the core software portions of the MCNP code. This effort will focus on fundamental structural changes to the underlying MCNP algorithms, data storage, and code architecture. These changes will directly improve code maintainability, reduce the development time for new features, improve the code performance, and make the code more flexible and adaptable for expected future computer systems. To move forward with new computer systems and additional new features, it is vital to have a solid base.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2011

Moving from gamma passing rates to patient DVH-based QA metrics in pretreatment dose QA

Purpose: The purpose of this work is to explore the usefulness of the gamma passing rate metric for per-patient, pretreatment dose QA and to validate a novel patient-dose/DVH-based method and its accuracy and correlation. Specifically, correlations between: (1) gamma passing rates for three 3D dosimeter detector geometries vs clinically relevant patient DVH-based metrics; (2) Gamma passing rates of whole patient dose grids vs DVH-based metrics, (3) gamma passing rates filtered by region of interest (ROI) vs DVH-based metrics, and (4) the capability of a novel software algorithm that estimates corrected patient Dose-DVH based on conventional phan-tom QA data are analyzed. Methods: Ninety six unique ''imperfect'' step-and-shoot IMRT plans were generated by applying four different types of errors on 24 clinical Head/Neck patients. The 3D patient doses as well as the dose to a cylindrical QA phantom were then recalculated using an error-free beam model to serve as a simulated measurement for comparison. Resulting deviations to the planned vs simulated measured DVH-based metrics were generated, as were gamma passing rates for a variety of difference/distance criteria covering: dose-in-phantom comparisons and dose-in-patient comparisons, with the in-patient results calculated both over the whole grid and per-ROI volume. Finally, patient dose and DVH were predicted using the conventional per-beam planar data as input into a commercial ''planned dose perturbation'' (PDP) algorithm, and the results of these predicted DVH-based metrics were compared to the known values. Results: A range of weak to moderate correlations were found between clinically relevant patient DVH metrics (CTV-D95, parotid D{sub mean}, spinal cord D1cc, and larynx D{sub mean}) and both 3D detector and 3D patient gamma passing rate (3%/3 mm, 2%/2 mm) for dose-in-phantom along with dose-in-patient for both whole patient volume and filtered per-ROI. There was considerable scatter in the gamma passing rate vs DVH-based metric curves. However, for the same input data, the PDP estimates were in agreement with actual patient DVH results. Conclusions: Gamma passing rate, even if calculated based on patient dose grids, has generally weak correlation to critical patient DVH errors. However, the PDP algorithm was shown to accurately predict the DVH impact using conventional planar QA results. Using patient-DVH-based metrics IMRT QA allows per-patient dose QA to be based on metrics that are both sensitive and specific. Further studies are now required to analyze new processes and action levels associated with DVH-based metrics to ensure effectiveness and practicality in the clinical setting.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2019

Natural and Engineered Features Supporting Environmental Performance of Idaho National Laboratory's Remote-Handled Low-Level Waste Disposal Facility - 19436

The Idaho National Laboratory's (INL's) Remote-Handled Low-Level Waste (RH LLW) Disposal Facility has been designed and constructed to receive waste generated at the INL site in support of the US DOE Office of Nuclear Energy (NE) and Naval Reactors (NR) missions. The facility has been designed to receive legacy RH LLW currently in storage at INL facilities and new waste generated by nuclear research programs. RH LLW to be received at the facility is solid waste consisting of surface contaminated materials; ion exchange resins used to purify cooling and canal water; and activated metal components generated during reactor core change outs and Naval spent fuel management; and nuclear R and D. Disposal of INL's RH LLW poses unique disposal challenges due to high radiation levels (contact rates up to 600 Sv/hr [60,000 Rem/hr]) that require remote handling and adequate shielding for transportation and disposal. The facility has been designed to meet the requirements of DOE Order 435.1, Radioactive Waste Management, including the all-pathways dose, air pathway dose, inadvertent intruder doses, and radon emissions limits. This paper presents an overview of natural and engineered design features that support the safety case and enhance the environmental performance of the facility. These features include location selection, use of reinforced pre-cast concrete vaults; a robust hydraulic drainage system; use of steel waste canisters for waste disposal; the facility monitoring system; facility layout; and crediting waste forms. The facility performance assessment (PA) developed to meet the requirements of DOE Order 435.1, credits each of these protective features. Releases from waste forms disposed of at this facility are limited by corrosion of the steel waste canisters which will ultimately allow contact with infiltrating water followed by transport of radionuclides from the vault system. The steel waste canisters were credited for their ability to limit water contact with the waste based on the demonstrated ability of the reinforced pre-caste concrete vaults to provide long-term structural protection of the steel waste canisters. Verification of hydraulic and concrete performance was conducted through laboratory data, field infiltration tests supported by a robust monitoring system, and numerical modeling. Releases into the vault system from activated metals are based on site-specific corrosion data. Radionuclide transport from the vault system from all waste forms is based on site-specific climatological, hydrologic, and stratigraphic data. At INL, the groundwater pathway historically and appropriately has received the most attention. By crediting aspects of the natural system, the engineered vault system, and the waste, estimated radiologic doses via the groundwater pathway are minimal. Air pathway doses were reduced by differentially crediting corrosion of aluminum and stainless steel activated metals resulting in the pathway being screened out of the PA. Groundwater and inadvertent intruder doses were reduced through selective facility layout. This paper provides an overview of the system-wide protective features incorporated into the facility design along with an extensive reference list to supporting technical papers and analyses that provide data and interpretation. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2013

Dose response of selected ion chambers in applied homogeneous transverse and longitudinal magnetic fields

Purpose: The magnetic fields of an integrated MR-Linac system will alter the paths of electrons that produce ions in the ionization chambers. The dose response of selected ion chambers is evaluated in the presence of varying transverse and longitudinal magnetic fields. The investigation is useful in calibration of therapeutic x-ray beams associated with MR-Linac systems. Methods: The Monte Carlo code PENELOPE was used to model the irradiation of NE2571, and PR06C ionization chambers in the presence of a transverse and longitudinal (with respect to the photon beam) magnetic fields of varying magnitude. The long axis of each chamber was simulated both parallel and perpendicular to the incident photon beam for each magnetic field case. The dose deposited in each chamber for each case was compared to the case with zero magnetic field by means of a ratio. The PR06C chamber's response was measured in the presence of a transverse magnetic field with field strengths ranging from 0.0 to 0.2 T to compare to simulated results. Results: The simulations and measured data show that in the presence of a transverse magnetic field there is a considerable dose response (maximum of 11% near 1.0 T in the ion chambers investigated, which depends on the magnitude of magnetic field, and relative orientation of the magnetic field, radiation beam, and ion chamber. Measurements made with the PR06C chamber verify these results in the region of measurement. In contrast, a longitudinal magnetic field produces only a slight increase in dose response (2% at 1.5 T) that rises slowly with increasing magnetic field and is seemingly independent of chamber orientation. Response trends were similar for the two ion chambers and relative orientations considered, but slight variations are present from chamber to chamber. Conclusions: Care must be taken when making ion chamber measurements in a transverse magnetic field. Ion chamber responses vary not only with transverse field strength, but with chamber orientation and type, and can be considerable. Longitudinal magnetic fields influence ion chamber responses relatively little (2% at 1.5 T), and only at field strengths in excess of 1.0 T.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

Feasibility of an image planning system for kilovoltage image-guided radiation therapy

Purpose: Image guidance has become a standard of care for many treatment scenarios in radiation therapy. This is most typically accomplished by use of kV x-ray devices mounted onto the linear accelerator (Linac) gantry that yield planar, fluoroscopic, and cone-beam computed tomography (CBCT) images. Image acquisition parameters are chosen via preset techniques that rely on broad categorizations in patient anatomy and imaging goal. However, the optimal imaging technique results in detectability of the features of interest while exposing the patient to minimum dose. Herein, the authors present an investigation into the feasibility of developing an image planning system (IPS) for radiotherapy.Methods: In this first phase, the authors focused on developing an algorithm to predict tissue contrast produced by a common radiotherapy planar imaging chain. Input parameters include a CT dataset and simulated planar imaging technique settings that include kV and mAs. Energy-specific attenuation through each voxel of the CT dataset was calculated in the algorithm to derive a net transmitted intensity. The response of the flat panel detector was integrated into the image simulation algorithm. Verification was conducted by comparing simulated and measured images using four phantoms. Comparisons were made in both high and low contrast settings, as well as changes in the geometric appearance due to image saturation. Results: The authors studied a lung nodule test object to assess the planning system's ability to predict object contrast and detectability. Verification demonstrated that the slope of the pixel intensities is similar, the presence of the nodule is evident, and image saturation at high mAs values is evident in both images. The appearance of the lung nodule is a function of the image detector saturation. The authors assessed the dimensions of the lung nodule in measured and simulated images. Good quantitative agreement affirmed the algorithm's predictive capabilities. The invariance of contrast with kVp and mAs prior to saturation was predicted, as well as the gradual loss of object detectability as saturation was approached. Small changes in soft tissue density were studied using a mammography step wedge phantom. Data were acquired at beam qualities of 80 and 120 kVp and over exposure values ranging from 0.04 to 500 mAs. The data showed good agreement in terms of the absolute value of pixel intensities predicted, as well as small variations across the step wedge pattern. The saturation pixel intensity was consistent between the two beam qualities studied. Boney tissue contrast was assessed using two abdominal phantoms. Measured and calculated values agree in terms of predicting the mAs value at which detector saturation, and subsequent loss of contrast occurs. The lack of variation in contrast over mAs values lower than 10 suggests that there is wide latitude for minimizing patient dose. Conclusions: The authors developed and tested an algorithm that can be used to assist in kV imaging technique selection during localization for radiotherapy. Phantom testing demonstrated the algorithm's predictive accuracy for both low and high contrast imaging scenarios. Detector saturation with subsequent loss of imaging detail, both in terms of object size and contrast were accurately predicted by the algorithm.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Fiducial marker-based correction for involuntary motion in weight-bearing C-arm CT scanning of knees. II. Experiment

Purpose: A C-arm CT system has been shown to be capable of scanning a single cadaver leg under loaded conditions by virtue of its highly flexible acquisition trajectories. In Part I of this study, using the 4D XCAT-based numerical simulation, the authors predicted that the involuntary motion in the lower body of subjects in weight-bearing positions would seriously degrade image quality and the authors suggested three motion compensation methods by which the reconstructions could be corrected to provide diagnostic image quality. Here, the authors demonstrate that a flat-panel angiography system is appropriate for scanning both legs of subjectsin vivo under weight-bearing conditions and further evaluate the three motion-correction algorithms using in vivo data. Methods: The geometry of a C-arm CT system for a horizontal scan trajectory was calibrated using the PDS-2 phantom. The authors acquired images of two healthy volunteers while lying supine on a table, standing, and squatting at several knee flexion angles. In order to identify the involuntary motion of the lower body, nine 1-mm-diameter tantalum fiducial markers were attached around the knee. The static mean marker position in 3D, a reference for motion compensation, was estimated by back-projecting detected markers in multiple projections using calibrated projection matrices and identifying the intersection points in 3D of the back-projected rays. Motion was corrected using three different methods (described in detail previously): (1) 2D projection shifting, (2) 2D deformable projection warping, and (3) 3D rigid body warping. For quantitative image quality analysis, SSIM indices for the three methods were compared using the supine data as a ground truth. Results: A 2D Euclidean distance-based metric of subjects’ motion ranged from 0.85 mm (±0.49 mm) to 3.82 mm (±2.91 mm) (corresponding to 2.76 to 12.41 pixels) resulting in severe motion artifacts in 3D reconstructions. Shifting in 2D, 2D warping, and 3D warping improved the SSIM in the central slice by 20.22%, 16.83%, and 25.77% in the data with the largest motion among the five datasets (SCAN5); improvement in off-center slices was 18.94%, 29.14%, and 36.08%, respectively. Conclusions: The authors showed that C-arm CT control can be implemented for nonstandard horizontal trajectories which enabled us to scan and successfully reconstruct both legs of volunteers in weight-bearing positions. As predicted using theoretical models, the proposed motion correction methods improved image quality by reducing motion artifacts in reconstructions; 3D warping performed better than the 2D methods, especially in off-center slices.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2017

Toward Personalized Dosimetry with {sup 32}P Microparticle Therapy for Advanced Pancreatic Cancer

Purpose: To develop a Monte Carlo model for patient-specific dosimetry of {sup 32}P microparticle localized internal radionuclide therapy for advanced pancreatic cancer. Methods and Materials: Spherical tumor geometries and a pancreatic phantom were modeled, as well as different 3-dimensional non-uniform clinical pancreatic geometries based on patient-specific ultrasound images. The dosimetry simulations modeled the dose distribution due to the energy spectrum of emitted beta particles. Results: The average dose for small (3-cm diameter) and large (6-cm diameter) spherical tumors was 111 Gy (for 7.6 MBq administered activity) and 128 Gy (for 58 MBq), respectively. For the clinical 3-dimensional geometries, on the basis of patient data, the mean doses delivered to the tumor were calculated to be in the range 102 to 113 Gy, with negligible dose to the pancreas for the smallest tumor volumes. The calculated dose distributions are highly non-uniform. For the largest tumor studied, the pancreas received approximately 6% of the tumor dose (5.7 Gy). Importantly, we found that because the smallest tumor studied exhibited the most dynamic changes in volume in response to the treatment, the dose to tumor and pancreas is significantly underestimated if a static tumor volume is assumed. Conclusions: These results demonstrate the dosimetry of {sup 32}P microparticle localized internal radionuclide therapy for pancreatic cancer and the possibility of developing personalized treatment strategies. The results also highlight the importance of considering the effects of non-uniform dose distributions and dynamic change of tumor mass during treatment on the dosimetry of the tumor and critical organs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Dosimetric Comparison in Breast Radiotherapy of 4 MV and 6 MV on Physical Chest Simulator

According to the World Health Organization (2014) breast cancer is the main cause of death by cancer in women worldwide. The biggest challenge of radiotherapy in the treatment of cancer is to deposit the entire prescribed dose homogeneously in the breast, sparing the surrounding tissue. In this context, this paper aimed at evaluating and comparing internal dose distribution in the mammary gland based on experimental procedures submitted to two distinct energy spectra produced in breast cancer radiotherapy. The methodology consisted of reproducing opposite parallel fields used in the treatment of breast tumors in a chest phantom. This simulator with synthetic breast, composed of equivalent tissue material (TE), was previously developed by the NRI Research Group (UFMG). The computer tomography (CT) scan of the simulator was obtained antecedently. The radiotherapy planning systems (TPS) in the chest phantom were performed in the ECLIPSE system from Varian Medical Systems and CAT 3D system from MEVIS. The irradiations were reproduced in the Varian linear accelerator, model SL- 20 Precise, 6 MV energy and Varian linear accelerator, 4 MV Clinac 6x SN11 model. Calibrations of the absorbed dose versus optical density from radiochromic films were generated in order to obtain experimental dosimetric distribution at the films positioned within the glandular and skin equivalent tissues of the chest phantom. The spatial dose distribution showed equivalence with the TPS on measurement data performed in the 6 MV spectrum. The average dose found in radiochromic films placed on the skin ranged from 49 to 79%, and from 39 to 49% in the mammary areola, for the prescribed dose. Dosimetric comparisons between the spectra of 4 and 6 MV, keeping the constant geometry of the fields applied in the same phantom, will be presented showing their equivalence in breast radiotherapy, as well as the variations will be discussed. To sum up, the dose distribution has reached the value expected in the breast dose of the 180 cGy in a wide range of the film in the glandular TE in both spectra. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗