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At least 253 records · Page 14
All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

MO-A-BRD-01: An Investigation of the Dynamic Response of a Novel Acousto-Optic Liquid Crystal Detector for Full-Field Transmission Ultrasound Breast Imaging

Purpose: To characterize the dynamic response of a novel acousto-optic (AO) liquid crystal detector for high-resolution transmission ultrasound breast imaging. Transient and steady-state lesion contrast were investigated to identify optimal transducer settings for our prototype imaging system consistent with the FDA limits of 1 W/cm{sup 2} and 50 J/cm{sup 2} on the incident acoustic intensity and the transmitted acoustic energy flux density. Methods: We have developed a full-field transmission ultrasound breast imaging system that uses monochromatic plane-wave illumination to acquire projection images of the compressed breast. The acoustic intensity transmitted through the breast is converted into a visual image by a proprietary liquid crystal detector operating on the basis of the AO effect. The dynamic response of the AO detector in the absence of an imaged breast was recorded by a CCD camera as a function of the acoustic field intensity and the detector exposure time. Additionally, a stereotactic needle biopsy breast phantom was used to investigate the change in opaque lesion contrast with increasing exposure time for a range of incident acoustic field intensities. Results: Using transducer voltages between 0.3 V and 0.8 V and exposure times of 3 minutes, a unique one-to-one mapping of incident acoustic intensity to steady-state optical brightness in the AO detector was observed. A transfer curve mapping acoustic intensity to steady-state optical brightness shows a high-contrast region analogous to the linear portion of the Hurter-Driffield curves of radiography. Using transducer voltages between 1 V and 1.75 V and exposure times of 90 s, the lesion contrast study demonstrated increasing lesion contrast with increasing breast exposure time and acoustic field intensity. Lesion-to-background contrast on the order of 0.80 was observed. Conclusion: Maximal lesion contrast in our prototype system can be obtained using the highest acoustic field intensity and the longest breast exposure time allowable under FDA standards. Department of Defense (DOD) Breast Cancer Research Program IDEA Award W81XWH-11-1-0332; National Institutes of Health (NIH) Grant T32 EB002103-21 from the National Institute of Biomedical Imaging and Bioengineering (NIBIB)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

TU-A-18C-01: ACR Accreditation Updates in CT, Ultrasound, Mammography and MRI

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, the ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up-to-date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, mammography, ultrasound, and computed tomography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements. Learning Objectives: To understand the requirements of the ACR MR accreditation program. The discussion will include accreditation of whole-body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed. To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program. To understand the new requirements of the ACR ultrasound accreditation program, and roles the physicist can play in annual equipment surveys and setting up and supervising the routine QC program. To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-A-17A-11: Implanted Brachytherapy Seed Movement Due to Transrectal Ultrasound Probe-Induced Prostate Deformation

Purpose: To characterize the movement of implanted brachytherapy seeds due to transrectal ultrasound probe-induced prostate deformation and to estimate the effects on prostate dosimetry. Methods: Implanted probe-in and probe-removed seed distributions were reconstructed for 10 patients using C-arm fluoroscopy imaging. The prostate was delineated on ultrasound and registered to the fluoroscopy seeds using a visible subset of seeds and residual needle tracks. A linear tensor and shearing model correlated the seed movement with position. The seed movement model was used to infer the underlying prostate deformation and to simulate the prostate contour without probe compression. Changes in prostate and surrogate urethra dosimetry were calculated. Results: Seed movement patterns reflecting elastic decompression, lateral shearing, and rectal bending were observed. Elastic decompression was characterized by anterior-posterior expansion and superior-inferior and lateral contractions. For lateral shearing, anterior movement up to 6 mm was observed for extraprostatic seeds in the lateral peripheral region. The average intra-prostatic seed movement was 1.3 mm, and the residual after linear modeling was 0.6 mm. Prostate D90 increased by 4 Gy on average (8 Gy max) and was correlated with elastic decompression. For selected patients, lateral shearing resulted in differential change in D90 of 7 Gy between anterior and posterior quadrants, and increase in whole prostate D90 of 4 Gy. Urethra D10 increased by 4 Gy. Conclusion: Seed movement upon probe removal was characterized. The proposed model captured the linear correlation between seed movement and position. Whole prostate dose coverage increased slightly, due to the small but systematic seed movement associated with elastic decompression. Lateral shearing movement increased dose coverage in the anterior-lateral region, at the expense of the posterior-lateral region. The effect on whole prostate D90 was smaller due to the subset of peripheral seeds involved, but lateral shearing movement can have greater consequences for local dose coverage.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-G-BRF-08: Robust Characterization and Patient Experience of a Time-Resolved Ultrasound System for Prostate Tracking

Purpose: Characterization of a time resolved ultrasound device (4D-US), used for localization and motion monitoring of prostate radiotherapy. Methods: The 4D-US system accuracy to reproduce prostate motion was investigated and artifacts were determined under detailed experimental and ultimately clinical conditions. Two fields of view (FOV) of 30 and 60 degrees and two corresponding acquisition speeds were evaluated under experimental conditions with gradual increased complexity. The reconstruction ability and trajectory tracking depends on the relative speed between the ultrasound probe and the moving object. Two different types of phantoms were developed; one capable of following a predetermined trajectory with variable speeds, and a second one designed to test the US ability to a track dynamically-deformed prostate. Four hypo-prostate patients (10fx) were monitored during the treatment to detect intrafraction motion. Results: Prostate speeds up to 6mm/s and 3mm/s can be successfully tracked by the system when using the small and large FOV, respectively. The system response time, calculated based on the speedinduced volumetric distortion, is dependent on the FOV, with 1.1s for the small FOV and 1.4s for the large FOV. The response time was also found dependent on the size of target, increasing from 1.4s to 1.7s for target diameters of 4cm to 2.8cm. The deformable dynamic phantom has shown that the system is able to successfully follow a highly-deformed, slowmoving prostate with an error < 0.5mm. The overall range of patient intrafraction motion was (−2.4 to 2.2)mm, (−2.6 to 2.4)mm, (−3.0 to 4.3)mm in the RL, SI and AP directions, respectively. Conclusion: The 4DUS system using a large FOV is appropriate to monitor the prostate motion as well as the adjacent organs at risk. However, infrequent abrupt motion can be problematic and the small FOV system is preferred for such patients, particularly for future applications as online prostate monitoring employed for MLC tracking.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Feasibility of vibro-acoustography with a quasi-2D ultrasound array transducer for detection and localizing of permanent prostate brachytherapy seeds: A pilot ex vivo study

Purpose: Effective permanent prostate brachytherapy (PPB) requires precise placement of radioactive seeds in and around the prostate. The impetus for this research is to examine a new ultrasound-based imaging modality, vibro-acoustography (VA), which may serve to provide a high rate of PPB seed detection while also effecting enhanced prostate imaging. The authors investigate the ability of VA, implemented on a clinical ultrasound (US) scanner and equipped with a quasi-2D (Q2D) array US transducer, to detect and localize PPB seeds in excised prostate specimens. Methods: Nonradioactive brachytherapy seeds were implanted into four excised cadaver prostates. A clinical US scanner equipped with a Q2D array US transducer was customized to acquire both US and C-scan VA images at various depths. The VA images were then used to detect and localize the implanted seeds in prostate tissue. To validate the VA results, computed tomography (CT) images of the same tissue samples were obtained to serve as the reference by which to evaluate the performance of VA in PPB seed detection. Results: The results indicate that VA is capable of accurately identifying the presence and distribution of PPB seeds with a high imaging contrast. Moreover, a large ratio of the PPB seeds implanted into prostate tissue samples could be detected through acquired VA images. Using CT-based seed identification as the standard, VA was capable of detecting 74%–92% of the implanted seeds. Additionally, the angular independency of VA in detecting PPB seeds was demonstrated through a well-controlled phantom experiment. Conclusions: Q2DVA detected a substantial portion of the seeds by using a 2D array US transducer in excised prostate tissue specimens. While VA has inherent advantages associated with conventional US imaging, it has the additional advantage of permitting detection of PPB seeds independent of their orientation. These results suggest the potential of VA as a method for PPB imaging that ultimately may allow US-based real-time intraoperative dosimetry.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

An image-guidance system for dynamic dose calculation in prostate brachytherapy using ultrasound and fluoroscopy

Purpose: Brachytherapy is a standard option of care for prostate cancer patients but may be improved by dynamic dose calculation based on localized seed positions. The American Brachytherapy Society states that the major current limitation of intraoperative treatment planning is the inability to localize the seeds in relation to the prostate. An image-guidance system was therefore developed to localize seeds for dynamic dose calculation. Methods: The proposed system is based on transrectal ultrasound (TRUS) and mobile C-arm fluoroscopy, while using a simple fiducial with seed-like markers to compute pose from the nonencoded C-arm. Three or more fluoroscopic images and an ultrasound volume are acquired and processed by a pipeline of algorithms: (1) seed segmentation, (2) fiducial detection with pose estimation, (3) seed matching with reconstruction, and (4) fluoroscopy-to-TRUS registration. Results: The system was evaluated on ten phantom cases, resulting in an overall mean error of 1.3 mm. The system was also tested on 37 patients and each algorithm was evaluated. Seed segmentation resulted in a 1% false negative rate and 2% false positive rate. Fiducial detection with pose estimation resulted in a 98% detection rate. Seed matching with reconstruction had a mean error of 0.4 mm. Fluoroscopy-to-TRUS registration had a mean error of 1.3 mm. Moreover, a comparison of dose calculations between the authors’ intraoperative method and an independent postoperative method shows a small difference of 7% and 2% forD{sub 90} and V{sub 100}, respectively. Finally, the system demonstrated the ability to detect cold spots and required a total processing time of approximately 1 min. Conclusions: The proposed image-guidance system is the first practical approach to dynamic dose calculation, outperforming earlier solutions in terms of robustness, ease of use, and functional completeness.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Poster — Thur Eve — 77: Implanted Brachythearpy Seed Movement due to Transrectal Ultrasound Probe-Induced Prostate Deformation

The study investigated the movement of implanted brachytherapy seeds upon transrectal US probe removal, providing insight into the underlying prostate deformation and an estimate of the impact on prostate dosimetry. Implanted seed distributions, one obtained with the prostate under probe compression and another with the probe removed, were reconstructed using C-arm fluoroscopy imaging. The prostate, delineated on ultrasound images, was registered to the fluoroscopy images using seeds and needle tracks identified on ultrasound. A deformation tensor and shearing model was developed to correlate probe-induced seed movement with position. Changes in prostate TG-43 dosimetry were calculated. The model was used to infer the underlying prostate deformation and to estimate the location of the prostate surface in the absence of probe compression. Seed movement patterns upon probe removal reflected elastic decompression, lateral shearing, and rectal bending. Elastic decompression was characterized by expansion in the anterior-posterior direction and contraction in the superior-inferior and lateral directions. Lateral shearing resulted in large anterior movement for extra-prostatic seeds in the lateral peripheral region. Whole prostate D90 increased up to 8 Gy, mainly due to the small but systematic seed movement associated with elastic decompression. For selected patients, lateral shearing movement increased prostate D90 by 4 Gy, due to increased dose coverage in the anterior-lateral region at the expense of the posterior-lateral region. The effect of shearing movement on whole prostate D90 was small compared to elastic decompression due to the subset of peripheral seeds involved, but is expected to have greater consequences for local dose coverage.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Prostate CT segmentation method based on nonrigid registration in ultrasound-guided CT-based HDR prostate brachytherapy

Purpose: The technological advances in real-time ultrasound image guidance for high-dose-rate (HDR) prostate brachytherapy have placed this treatment modality at the forefront of innovation in cancer radiotherapy. Prostate HDR treatment often involves placing the HDR catheters (needles) into the prostate gland under the transrectal ultrasound (TRUS) guidance, then generating a radiation treatment plan based on CT prostate images, and subsequently delivering high dose of radiation through these catheters. The main challenge for this HDR procedure is to accurately segment the prostate volume in the CT images for the radiation treatment planning. In this study, the authors propose a novel approach that integrates the prostate volume from 3D TRUS images into the treatment planning CT images to provide an accurate prostate delineation for prostate HDR treatment. Methods: The authors’ approach requires acquisition of 3D TRUS prostate images in the operating room right after the HDR catheters are inserted, which takes 1–3 min. These TRUS images are used to create prostate contours. The HDR catheters are reconstructed from the intraoperative TRUS and postoperative CT images, and subsequently used as landmarks for the TRUS–CT image fusion. After TRUS–CT fusion, the TRUS-based prostate volume is deformed to the CT images for treatment planning. This method was first validated with a prostate-phantom study. In addition, a pilot study of ten patients undergoing HDR prostate brachytherapy was conducted to test its clinical feasibility. The accuracy of their approach was assessed through the locations of three implanted fiducial (gold) markers, as well as T2-weighted MR prostate images of patients. Results: For the phantom study, the target registration error (TRE) of gold-markers was 0.41 ± 0.11 mm. For the ten patients, the TRE of gold markers was 1.18 ± 0.26 mm; the prostate volume difference between the authors’ approach and the MRI-based volume was 7.28% ± 0.86%, and the prostate volume Dice overlap coefficient was 91.89% ± 1.19%. Conclusions: The authors have developed a novel approach to improve prostate contour utilizing intraoperative TRUS-based prostate volume in the CT-based prostate HDR treatment planning, demonstrated its clinical feasibility, and validated its accuracy with MRIs. The proposed segmentation method would improve prostate delineations, enable accurate dose planning and treatment delivery, and potentially enhance the treatment outcome of prostate HDR brachytherapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-J-65: Motion Difference Between the Pancreas and Nearby Veins for Pancreas Motion Monitoring Using Ultrasound During Radiation Therapy

Purpose: As it is generally difficult to outline the pancreas on an ultrasound b-mode image, visualized structures such as the portal or the splenic veins are assumed to have the same motion as the pancreas. These structures can be used as a surrogate for monitoring pancreas motion during radiation therapy (RT) delivery using ultrasound. To verify this assumption, we studied the motion difference between the head of the pancreas, the portal vein, the tail of the pancreas, and splenic vein. Methods: 4DCT data acquired during RT simulation were analyzed for a total of 5 randomly selected patients with pancreatic cancer. The data was sorted into 10 respiratory phases from 0% to 90% (0%: end of the inspiration, 50%: end of expiration) . The head of the pancreas (HP), tail of the pancreas (TP), portal vein (PV), and splenic vein (SV) were contoured on all 10 phases. The volume change and motion were measured in the left-right (LR), anterior-superior (AP), and superior-inferior (SI) directions. Results: The volume change for all patients/phases were: 1.2 ± 3% for HP, 0.78 ± 1.6% for PV, 2.5 ± 2.9% for TP, and 0.53 ± 2.1% for SV. Motion for each structure was estimated from the centroid displacements due to the uniformity of the structures and the small volume change. The measured motion between HP and PV was: LR: 0.1 ± 0.17 mm, AP: 0.04 ± 0.1 mm, SI: 0.17 ± 0.16 mm and between TP and the PV was: LR: 0.05 ± 0.3 mm, AP: 0.1 ± 0.4 mm, SI: 0.01 ± 0.022 mm. Conclusion: There are small motion differences between the portal vein and the head of the pancreas, and the splenic vein and the tail of the pancreas. This suggests the feasibility of utilizing these features for monitoring the pancreas motion during radiation therapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Intercostal high intensity focused ultrasound for liver ablation: The influence of beam shaping on sonication efficacy and near-field risks

Purpose: One of the major issues in high intensity focused ultrasound ablation of abdominal lesions is obstruction of the ultrasound beam by the thoracic cage. Beam shaping strategies have been shown by several authors to increase focal point intensity while limiting rib exposure. However, as rib obstruction leaves only part of the aperture available for energy transmission, conserving total emitted acoustic power, the intensity in the near-field tissues inherently increases after beam shaping. Despite of effective rib sparing, those tissues are therefore subjected to increased risk of thermal damage. In this study, for a number of clinically representative intercostal sonication geometries, modeling clinically available hardware, the effect of beam shaping on both the exposure of the ribs and near-field to acoustic energy was evaluated and the implications for the volumetric ablation rate were addressed. Methods: A relationship between rib temperature rise and acoustic energy density was established by means of in vivo MR thermometry and simulations of the incident acoustic energy for the corresponding anatomies. This relationship was used for interpretation of rib exposure in subsequent numerical simulations in which rib spacing, focal point placement, and the focal point trajectory were varied. The time required to heat a targeted region to 65 °C was determined without and with the application of beam shaping. The required sonication time was used to calculate the acoustic energy density at the fat–muscle interface and at the surface of the ribs. At the fat–muscle interface, exposure was compared to available literature data and rib exposure was interpreted based on the earlier obtained relation between measured temperature rise and simulated acoustic energy density. To estimate the volumetric ablation rate, the cool-down time between periods of energy exposure was estimated using a time-averaged power limit of 100 kJ/h. Results: At the level of the ribs, the temperature rise–energy density proportionality constant was estimated to be 6.0–7.6 °C/(J/mm{sup 2}). Beam shaping by the geometric shadow method typically reduces the acoustic intensity a factor of 2, considering the 1 cm{sup 2} with the highest exposure. For a 4 mm diameter circular sonication trajectory, the near-field energy limit of 2.5 J/mm{sup 2} was exceeded for all considered geometries. The estimated rib temperature was in all but one (sonication 50 mm behind the ribs, with 15 mm rib spacing and a 4 mm diameter circular sonication trajectory) of the considered scenarios within acceptable limits. For those sonication scenarios where a single sonication is considered safe both in terms of near-field as well as rib heating, volumetric ablation rates in the order of 1 ml/h are estimated. Conclusions: Intercostal sonication is associated with an increased risk of near-field overheating. This risk is strongly dependent on the considered rib spacing, the placement of the focus behind the ribs, and the selected sonication trajectory. For the hardware under simulation, obstruction by the thoracic cage renders ablations of clinically relevant volumes within a practical time-frame unfeasible in a large part of the liver. Improvements maybe expected from transducer designs with a larger active surface and/or nonlinear sonication strategies.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-EF-BRA-12: Magnetic Resonance- Guided High-Intensity Focused Ultrasound for Localized Ablation of Head and Neck Tissue Structures: A Feasibility Study in An Animal Model

Purpose: High-intensity focused ultrasound (HIFU) ablation is feasible in the head and neck [1]. This study aims to expand upon these findings to assess the feasibility of treatment planning and monitoring via magnetic resonance imaging (MRI) guidance using a clinical MR-guided HIFU platform. Methods: Two 31 kg pigs were anaesthetized, shaved, and positioned prone on the HIFU table (Sonalleve, Philips Healthcare, Vantaa, Finland). The necks were acoustically coupled to the integrated transducer using gel pads and degassed water. MR imaging verified acoustic coupling and facilitated target selection in the thyroid and thymus. Targets were thermally ablated with 130–200 W of acoustic power over a period of 16 s at a frequency of 1.2 MHz while being monitored through real-time, multi-planar MR-thermometry. Contrast-enhanced MR imaging was used to assess treatment efficacy. Post-treatment, animals were euthanized and sonicated tissues were harvested for histology assessment. Results: MR-thermometry, post-contrast-imaging, and gross pathology demonstrated that the system was capable of causing localized thermal ablation in both the thyroid and the thymus without damaging the aerodigestive tract. In one animal, superficial bruising was observed in the ultrasound beam path. Otherwise, there were no adverse events. Analysis of the tissue histology found regions of damage consistent with acute thermal injury at the targeted locations. Conclusion: It is feasible to use a clinical MR-guided HIFU platform for extracorporeal ablation of porcine head and neck tissues. MR guidance and thermometry are sufficient to target and monitor treatment in the thyroid region, despite the presence of the inhomogeneous aerodigestive tract. Further study is necessary to assess efficacy and survival using a tumor model, and to examine what modifications should be made to the transducer positioning system and associated patient positioning aids to adapt it for clinical head and neck targets.Reference:[1] Esnault et al. (2011). Thyroid, 21(9), 965– 973. Funding support provided by Philips Healthcare. Ari Partanen is a paid employee of Philips Healthcare.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Computer-aided diagnosis for classifying benign versus malignant thyroid nodules based on ultrasound images: A comparison with radiologist-based assessments

Purpose: To develop a semiautomated computer-aided diagnosis (CAD) system for thyroid cancer using two-dimensional ultrasound images that can be used to yield a second opinion in the clinic to differentiate malignant and benign lesions. Methods: A total of 118 ultrasound images that included axial and longitudinal images from patients with biopsy-confirmed malignant (n = 30) and benign (n = 29) nodules were collected. Thyroid CAD software was developed to extract quantitative features from these images based on thyroid nodule segmentation in which adaptive diffusion flow for active contours was used. Various features, including histogram, intensity differences, elliptical fit, gray-level co-occurrence matrixes, and gray-level run-length matrixes, were evaluated for each region imaged. Based on these imaging features, a support vector machine (SVM) classifier was used to differentiate benign and malignant nodules. Leave-one-out cross-validation with sequential forward feature selection was performed to evaluate the overall accuracy of this method. Additionally, analyses with contingency tables and receiver operating characteristic (ROC) curves were performed to compare the performance of CAD with visual inspection by expert radiologists based on established gold standards. Results: Most univariate features for this proposed CAD system attained accuracies that ranged from 78.0% to 83.1%. When optimal SVM parameters that were established using a grid search method with features that radiologists use for visual inspection were employed, the authors could attain rates of accuracy that ranged from 72.9% to 84.7%. Using leave-one-out cross-validation results in a multivariate analysis of various features, the highest accuracy achieved using the proposed CAD system was 98.3%, whereas visual inspection by radiologists reached 94.9% accuracy. To obtain the highest accuracies, “axial ratio” and “max probability” in axial images were most frequently included in the optimal feature sets for the authors’ proposed CAD system, while “shape” and “calcification” in longitudinal images were most frequently included in the optimal feature sets for visual inspection by radiologists. The computed areas under curves in the ROC analysis were 0.986 and 0.979 for the proposed CAD system and visual inspection by radiologists, respectively; no significant difference was detected between these groups. Conclusions: The use of thyroid CAD to differentiate malignant from benign lesions shows accuracy similar to that obtained via visual inspection by radiologists. Thyroid CAD might be considered a viable way to generate a second opinion for radiologists in clinical practice.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-G-BRA-02: Development of a Learning Based Block Matching Algorithm for Ultrasound Tracking in Radiotherapy

Purpose: To develop an ultrasound learning-based tracking algorithm with the potential to provide real-time motion traces of anatomy-based fiducials that may aid in the effective delivery of external beam radiation. Methods: The algorithm was developed in Matlab R2015a and consists of two main stages: reference frame selection, and localized block matching. Immediately following frame acquisition, a normalized cross-correlation (NCC) similarity metric is used to determine a reference frame most similar to the current frame from a series of training set images that were acquired during a pretreatment scan. Segmented features in the reference frame provide the basis for the localized block matching to determine the feature locations in the current frame. The boundary points of the reference frame segmentation are used as the initial locations for the block matching and NCC is used to find the most similar block in the current frame. The best matched block locations in the current frame comprise the updated feature boundary. The algorithm was tested using five features from two sets of ultrasound patient data obtained from MICCAI 2014 CLUST. Due to the lack of a training set associated with the image sequences, the first 200 frames of the image sets were considered a valid training set for preliminary testing, and tracking was performed over the remaining frames. Results: Tracking of the five vessel features resulted in an average tracking error of 1.21 mm relative to predefined annotations. The average analysis rate was 15.7 FPS with analysis for one of the two patients reaching real-time speeds. Computations were performed on an i5-3230M at 2.60 GHz. Conclusion: Preliminary tests show tracking errors comparable with similar algorithms at close to real-time speeds. Extension of the work onto a GPU platform has the potential to achieve real-time performance, making tracking for therapy applications a feasible option. This work is partially funded by NIH grant R01CA190298.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-JeP1-09: Evaluation of Transperineal Ultrasound Imaging as a Potential Solution for Target Tracking During Ablative Body Radiotherapy for Prostate Cancer

Purpose: Prostate SABR is emerging as a clinically viable, potentially cost effective alternative to prostate IMRT but its adoption is contingent on providing solutions for accurate tracking during beam delivery. Our goal is to evaluate the performance of the Clarity Autoscan ultrasound monitoring system for inter-fractional prostate motion tracking in both phantoms and in-vivo. Methods: In-vivo evaluation was performed under IRB protocol to allow data collection in prostate patients treated with VMAT whereby prostate was imaged through the acoustic window of the perineum. The probe was placed before KV imaging and real-time tracking was started and continued until the end of treatment. Initial absolute 3D positions of fiducials were estimated from KV images. Fiducial positions in MV images subsequently acquired during beam delivery were compared with predicted positions based on Clarity estimated motion. Results: Phantom studies with motion amplitudes of ±1.5, ±3, ±6 mm in lateral direction and ±2 mm in longitudinal direction resulted in tracking errors of −0.03 ± 0.3, −0.04 ± 0.6, −0.2 ± 0.9 mm, respectively, in lateral direction and −0.05 ± 0.30 mm in longitudinal direction. In phantom, measured and predicted fiducial positions in MV images were within 0.1 ± 0.6 mm. Four patients consented to participate in the study and data was acquired over a total of 140 fractions. MV imaging tracking was possible in about 75% of the time (due to occlusion of fiducials) compared to 100% with Clarity. Overall range of estimated motion by Clarity was 0 to 4.0 mm. In-vivo fiducial localization error was 1.2 ± 1.0 mm compared to 1.8 ± 1.9 mm if not taking Clarity estimated motion into account. Conclusion: Real-time transperineal ultrasound tracking reduces uncertainty in prostate position due to intrafractional motion. Research was supported by Elekta.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

WE-DE-BRA-03: Construction of An Ultrasound Guidance Platform for Image-Guided Radiotherapy with the Intent to Treat Transitional Cell Carcinoma

Purpose: Ultrasound (US) is a noninvasive, nonradiographic imaging technique with high spatial and temporal resolution that can be used for localizing soft-tissue structures and tumors in real-time during radiotherapy (inter- and intra-fraction). A detailed methodology integrating 3D-US within RT is presented. This method is easier to adopt into current treatment protocol than current US based systems and reduces user variability for image acquisition, thus eliminating transducer induced changes that limit CT planning system. Methods: We designed an in-house integrated US manipulator and platform to relate CT, 3D-US and linear accelerator coordinate systems. To validate the platform, an agar-based phantom with measured densities and speed-of-sound consistent with tissues surrounding the bladder, was rotated (0–45°) resulting in translations (up to 55mm) relative to the CT and US coordinate systems. After acquiring and integrating CT and US images into the treatment planning system, US-to-US and US-to-CT images were co-registered to re-align the phantom relative to the linear accelerator. Errors in the transformation matrix components were calculate to determine precision of this method under different patient positions. Results: Statistical errors from US-US registrations for different patient orientations ranged from 0.06–1.66mm for x, y, and z translational components, and 0.00–1.05° for rotational components. Statistical errors from US-CT registrations were 0.23–1.18mm for the x, y and z translational components, and 0.08–2.52° for the rotational components. Conclusion: Based on our result, this is consistent with currently used techniques for positioning prostate patients if couch re-positioning is less than a 5 degree rotation. We are now testing this on a dog patient to obtain both inter and intra-fractional positional errors. Additional design considerations include the future use of ultrasound-based functionality (photoacoustics, radioacoustics, Doppler) to monitor blood flow and hypoxia and/or in-vivo dosimetry for applications in other therapeutic techniques, such as hyperthermia, anti-angiogenesis, and particle therapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Poster - 10: QA of Ultrasound Images for Prostate Brachytherapy

Purpose: The current QA protocol of ultrasound systems used in prostate brachytherapy (TG128) addresses geometrical verifications, but the scope of evaluation of image quality is limited. We recognized importance of the latter in routine practice, and designed a protocol for QA of the images. Methods: Images of an ultrasound prostate phantom (CIRS053) were collected with BK Flex Focus 400. The images were saved as bmp after adjusting the gain to 50% for consistent results. Mean pixel values and signal to noise ratio were inspected in the representative sections of the phantom, including the mock prostate and the unechoic medium. Constancy of these numbers over a one year period was looked at. Results: The typical intensity in the mock prostate region in the transverse images ranged between 95 and 118 (out of 256), and the signal to noise was about 10. The intensity in the urethra region was about 170±40, and the unechoic medium was 2±2. The mean and the signal to noise ratio remained almost unchanged after a year, while the signal in the unechoic medium increased to about 7±4. Similar values were obtained in the sagittal images. Conclusions: The image analysis discussed above allows quick evaluation of constancy of the image quality. This may be also useful in troubleshooting image-quality problems during routine exams, which might not be due to deterioration of the US system, but other reasons, e.g. variations in tissue properties or air being trapped between the probe and the anatomy.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2021

In situ characterization of laser-generated melt pools using synchronized ultrasound and high-speed X-ray imaging

Metal additive manufacturing is a fabrication method that forms a part by fusing layers of powder to one another. An energy source, such as a laser, is commonly used to heat the metal powder sufficiently to cause a molten pool to form, which is known as the melt pool. The melt pool can exist in the conduction or the keyhole mode where the material begins to rapidly evaporate. The interaction between the laser and the material is physically complex and difficult to predict or measure. Here, high-speed X-ray imaging was combined with immersion ultrasound to obtain synchronized measurements of stationary laser-generated melt pools. Furthermore, two-dimensional and three-dimensional finite-element simulations were conducted to help explain the ultrasonic response in the experiments. In particular, the time-of-flight and amplitude in pulse-echo configuration were observed to have a linear relationship to the depth of the melt pool. These results are promising for the use of ultrasound to characterize the melt pool behavior and for finite-element simulations to aid in interpretation.

42 ENGINEERING↗
DOE OSTI2023

In-process volumetric sensing of defects in multiple parts during powder bed fusion using ultrasound

This letter reports on the integration of eight ultrasonic transducers into a build substrate for individual in-process monitoring of eight parts fabricated using powder bed fusion additive manufacturing. Ultrasound is shown to be able to sense poor fusion of parts to the substrate and also sensitivity to porosity. This technique demonstrates the utility of ultrasound as one of a few techniques able to interrogate the volume of additively manufactured parts during the process. Additionally, the ability to measure several parts during a single build can be used for efficient process parameter development studies, as the ultrasonic measurements can offer rapid information about part quality and integrity.

Kizer, Nathan J.↗