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At least 271 records · Page 15

GIS Supported Optimal Site Selection for Coastal Structure Integrated Wave Energy Converters: Preprint

There is an urgent need for adaptative engineering towards more resilient coastal communities, and Coastal Structure Integrated Wave Energy Converters (CSI-WECs) are a promising solution. CSI-WECs are wave energy converters (WECs) that are built into coastal protection structures, such as breakwaters. These devices provide the dual benefits of coastal protection and local energy production, and unlike other WECs, maximizing energy production is not always the main objective. CSI-WECs are located near the shore, where the wave resource is lower, thus site selection for these devices differs from the typical offshore WECs. Other attributes of a site that may be more important than wave power include existing coastal structures, port proximity, electric transmission line proximity, and location of disadvantaged communities. Geospatial information systems (GIS) interfaces can be used to easily visualize geospatial data that represents these difference kinds of criteria important for the determination of optimal marine energy sites. Multi-Criteria Decision Analysis (MCDA) is a geospatial analysis method that allows for the evaluation of multiple, usually overlapping, criteria. This project applies GIS-based MCDA methods to two distinct case studies in Puerto Rico and California for CSI-WEC site selection. The two study sites contrast in terms of wave resource, coastal hazards, and local energy needs. This research demonstrates the utility of applying an MCDA framework within GIS to facilitate efficient site selection for devices with unique characteristics in different use cases.

coastal protection↗

Intensity Modulated Proton Therapy for Craniospinal Irradiation: Organ-at-Risk Exposure and a Low-Gradient Junctioning Technique

Purpose: To compare field junction robustness and sparing of organs at risk (OARs) during craniospinal irradiation (CSI) using intensity modulated proton therapy (IMPT) to conventional passively scattered proton therapy (PSPT). Methods and Materials: Ten patients, 5 adult and 5 pediatric patients, previously treated with PSPT-based CSI were selected for comparison. Anterior oblique cranial fields, using a superior couch rotation, and posterior spinal fields were used for IMPT planning. To facilitate low-gradient field junctioning along the spine, the inverse-planning IMPT technique was divided into 3 stages. Dose indices describing target coverage and normal tissue dose, in silico error modeling, and film dosimetry were used to assess plan quality. Results: Field junction robustness along the spine was improved using the staged IMPT planning technique, reducing the worst case impact of a 4-mm setup error from 25% in PSPT to <5% of prescription dose. This was verified by film dosimetry for clinical delivery. Exclusive of thyroid dose in adult patients, IMPT plans demonstrated sparing of organs at risk as good or better than PSPT. Coverage of the cribriform plate for pediatric (V95% [percentage of volume of the target receiving at least 95% of the prescribed dose]; 87 ± 11 vs 92 ± 7) and adult (V95%; 94 ± 7 vs 100 ± 1) patients and the clinical target in pediatric (V95%; 98 ± 2 vs 100 ± 1) and adult (V95%; 100 ± 1 vs 100 ± 1) patients for PSPT and IMPT plans, respectively, were comparable or improved. For adult patients, IMPT target dose inhomogeneity was increased, as determined by heterogeneity index (HI) and inhomogeneity coefficient (IC). IMPT lowered maximum spinal cord dose, improved spinal dose homogeneity, and reduced exposure to other OARs. Conclusions: IMPT has the potential to improve CSI plan quality and the homogeneity of intrafractional dose at match lines. The IMPT approach developed may also simplify treatments and reduce workload per patient relative to PSPT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Clinical Outcomes Among Children With Standard-Risk Medulloblastoma Treated With Proton and Photon Radiation Therapy: A Comparison of Disease Control and Overall Survival

Purpose: The purpose of this study was to compare long-term disease control and overall survival between children treated with proton and photon radiation therapy (RT) for standard-risk medulloblastoma. Methods and Materials: This multi-institution cohort study includes 88 children treated with chemotherapy and proton (n=45) or photon (n=43) RT between 2000 and 2009. Overall survival (OS), recurrence-free survival (RFS), and patterns of failure were compared between the 2 cohorts. Results: Median (range) age was 6 years old at diagnosis (3-21 years) for proton patients versus 8 years (3-19 years) for photon patients (P=.011). Cohorts were similar with respect to sex, histology, extent of surgical resection, craniospinal irradiation (CSI) RT dose, total RT dose, whether the RT boost was delivered to the posterior fossa (PF) or tumor bed (TB), time from surgery to RT start, or total duration of RT. RT consisted of a median (range) CSI dose of 23.4 Gy (18-27 Gy) and a boost of 30.6 Gy (27-37.8 Gy). Median follow-up time is 6.2 years (95% confidence interval [CI]: 5.1-6.6 years) for proton patients versus 7.0 years (95% CI: 5.8-8.9 years) for photon patients. There was no significant difference in RFS or OS between patients treated with proton versus photon RT; 6-year RFS was 78.8% versus 76.5% (P=.948) and 6-year OS was 82.0% versus 87.6%, respectively (P=.285). On multivariate analysis, there was a trend for longer RFS with females (P=.058) and higher CSI dose (P=.096) and for longer OS with females (P=.093). Patterns of failure were similar between the 2 cohorts (P=.908). Conclusions: Disease control with proton and photon radiation therapy appears equivalent for standard risk medulloblastoma.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Intensity-modulated radiation therapy and volumetric-modulated arc therapy for adult craniospinal irradiation—A comparison with traditional techniques

Craniospinal irradiation (CSI) poses a challenging planning process because of the complex target volume. Traditional 3D conformal CSI does not spare any critical organs, resulting in toxicity in patients. Here the dosimetric advantages of intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are compared with classic conformal planning in adults for both cranial and spine fields to develop a clinically feasible technique that is both effective and efficient. Ten adult patients treated with CSI were retrospectively identified. For the cranial fields, 5-field IMRT and dual 356° VMAT arcs were compared with opposed lateral 3D conformal radiotherapy (3D-CRT) fields. For the spine fields, traditional posterior-anterior (PA) PA fields were compared with isocentric 5-field IMRT plans and single 200° VMAT arcs. Two adult patients have been treated using this IMRT technique to date and extensive quality assurance, especially for the junction regions, was performed. For the cranial fields, the IMRT technique had the highest planned target volume (PTV) maximum and was the least efficient, whereas the VMAT technique provided the greatest parotid sparing with better efficiency. 3D-CRT provided the most efficient delivery but with the highest parotid dose. For the spine fields, VMAT provided the best PTV coverage but had the highest mean dose to all organs at risk (OAR). 3D-CRT had the highest PTV and OAR maximum doses but was the most efficient. IMRT provides the greatest OAR sparing but the longest delivery time. For those patients with unresectable disease that can benefit from a higher, definitive dose, 3D-CRT–opposed laterals are the most clinically feasible technique for cranial fields and for spine fields. Although inefficient, the IMRT technique is the most clinically feasible because of the increased mean OAR dose with the VMAT technique. Quality assurance of the beams, especially the junction regions, is essential.

61 RADIATION PROTECTION AND DOSIMETRY↗

A single-gradient junction technique to replace multiple-junction shifts for craniospinal irradiation treatment

Craniospinal irradiation (CSI) requires abutting fields at the cervical spine. Junction shifts are conventionally used to prevent setup error–induced overdosage/underdosage from occurring at the same location. This study compared the dosimetric differences at the cranial-spinal junction between a single-gradient junction technique and conventional multiple-junction shifts and evaluated the effect of setup errors on the dose distributions between both techniques for a treatment course and single fraction. Conventionally, 2 lateral brain fields and a posterior spine field(s) are used for CSI with weekly 1-cm junction shifts. We retrospectively replanned 4 CSI patients using a single-gradient junction between the lateral brain fields and the posterior spine field. The fields were extended to allow a minimum 3-cm field overlap. The dose gradient at the junction was achieved using dose painting and intensity-modulated radiation therapy planning. The effect of positioning setup errors on the dose distributions for both techniques was simulated by applying shifts of ± 3 and 5 mm. The resulting cervical spine doses across the field junction for both techniques were calculated and compared. Dose profiles were obtained for both a single fraction and entire treatment course to include the effects of the conventional weekly junction shifts. Compared with the conventional technique, the gradient-dose technique resulted in higher dose uniformity and conformity to the target volumes, lower organ at risk (OAR) mean and maximum doses, and diminished hot spots from systematic positioning errors over the course of treatment. Single-fraction hot and cold spots were improved for the gradient-dose technique. The single-gradient junction technique provides improved conformity, dose uniformity, diminished hot spots, lower OAR mean and maximum dose, and one plan for the entire treatment course, which reduces the potential human error associated with conventional 4-shifted plans.

61 RADIATION PROTECTION AND DOSIMETRY↗

NO 2 -mediated voloxidation for iodine separation from cesium iodide surrogates

Heterogeneous NO 2 -mediated oxidation of uranium, also known as advanced voloxidation, is a proposed head-end reprocessing method for used nuclear fuel. An advantage of advanced voloxidation is the removal of volatile fission products, which complicate downstream separation and containment challenges leading to increased processing economics. Iodine, one of the volatile species of interest, has exhibited varied results in this process. Using CsI as a surrogate material, this work mimics the effect of NO 2 -based voloxidation on iodine and sheds light on the factors that influence the solid–gas phase reaction. Solid-state analysis using Fourier transform infrared attenuated total reflectance spectroscopy and scanning electron microscopy with energy-dispersive X-ray spectroscopy confirmed the conversion of CsI to CsNO 3 . Iodine separation ranged from 46% to 100% across multiple tests. Iodine separation was most effective when multiple recharges of NO 2 were administered. In conclusion, at the bench scale, liberating iodine from CsI appears to occur within 1 h, but the presence of surface H 2 O and the composition of the NO x reagent mixtures greatly influence its success.

advanced voloxidation↗

Un-collimated single-photon imaging system for high-sensitivity small animal and plant imaging

In preclinical single-photon emission computed tomography (SPECT) system development the primary objective has been to improve spatial resolution by using novel parallel-hole or multi-pinhole collimator geometries. Furthermore, such high-resolution systems have relatively poor sensitivity (typically 0.01% to 0.1%). In contrast, a system that does not use collimators can achieve very high-sensitivity. Here we present a high-sensitivity un-collimated detector single-photon imaging (UCD-SPI) system for the imaging of both small animals and plants. This scanner consists of two thin, closely spaced, pixelated scintillator detectors that use NaI(Tl), CsI(Na), or BGO. The performance of the system has been characterized by measuring sensitivity, spatial resolution, linearity, detection limits, and uniformity. With 99m Tc (140 keV) at the center of the field of view (20 mm scintillator separation), the sensitivity was measured to be 31.8% using the NaI(Tl) detectors and 40.2% with CsI(Na). The best spatial resolution (FWHM when the image formed as the geometric mean of the two detector heads, 20 mm scintillator separation) was 19.0 mm for NaI(Tl) and 11.9 mm for CsI(Na) at 140 keV, and 19.5 mm for BGO at 1116 keV, which is somewhat degraded compared to the cm-scale resolution obtained with only one detector head and a close source. The quantitative accuracy of the system’s linearity is better than 2% with detection down to activity levels of 100 nCi. Two in vivo animal studies (a renal scan using 99m Tc MAG-3 and a thyroid scan with 123 I) and one plant study (a 99m TcO 4 - xylem transport study) highlight the unique capabilities of this UCD-SPI system. From the renal scan, we observe approximately a one thousand-fold increase in sensitivity compared to the Siemens Inveon SPECT/CT scanner. In conclusion, UCD-SPI is useful for many imaging tasks that do not require excellent spatial resolution, such as high-throughput screening applications, simple radiotracer uptake studies in tumor xenografts, dynamic studies where very good temporal resolution is critical, or in planta imaging of radioisotopes at low concentrations.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A novel diamond-like carbon based photocathode for PICOSEC Micromegas detectors

The PICOSEC Micromegas (MM) detector is a precise timinggaseous detector based on a MM detector operating in a two-stageamplification mode and a Cherenkov radiator. Prototypes equippedwith cesium iodide (CsI) photocathodes have shown promising timeresolutions as precise as 24 picoseconds (ps) for Minimum IonizingParticles. However, due to the high hygroscopicity andsusceptibility to ion bombardment of the CsI photocathodes,alternative photocathode materials are needed to improve therobustness of PICOSEC MM. Diamond-like Carbon (DLC) film have beenintroduced as a novel robust photocathode material, which have shownpromising results. A batch of DLC photocathodes with differentthicknesses were produced and evaluated using ultraviolet light. Thequantum efficiency measurements indicate that the optimizedthickness of the DLC photocathode is approximately3 nm. Furthermore, DLC photocathodes show good resistance to ionbombardment in aging test compared to the CsI photocathode. Finally,a PICOSEC MM prototype equipped with DLC photocathodes was tested inmuon beams. A time resolution of around 42 ps with a detectionefficiency of 97% for 150 GeV/c muons were obtained. These resultsindicate the great potential of DLC as a photocathode for thePICOSEC MM detector.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Direct detection of sub-GeV dark matter with scintillating targets

We suggest a novel experimental concept for detecting MeV-to-GeV-mass dark matter, in which the dark matter scatters off electrons in a scintillating target and produces a signal of one or a few photons. New large-area photodetectors are needed to measure the photon signal with negligible dark counts, which could be constructed from transition edge sensor (TES) or microwave kinetic inductance detector (MKID) technology. Alternatively, detecting two photons in coincidence may allow the use of conventional photodetectors like photomultiplier tubes. Here we describe why scintillators may have distinct advantages over other experiments searching for a low ionization signal from sub-GeV dark matter, as there are fewer potential sources of spurious backgrounds. We discuss various target choices, but focus on calculating the expected dark matter-electron scattering rates in three scintillating crystals: sodium iodide (NaI), cesium iodide (CsI), and gallium arsenide (GaAs). Among these, GaAs has the lowest band gap (1.52 eV) compared to NaI (5.9 eV) or CsI (6.4 eV), which in principle allows it to probe dark matter masses as low as ~0.5 MeV, compared to ~1.5 MeV with NaI or CsI. We compare these scattering rates with those expected in silicon (Si) and germanium (Ge). The proposed experimental concept presents an important complementary path to existing efforts, and its potential advantages may make it the most sensitive direct-detection probe of dark matter down to MeV masses.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Silicon Photomultipliers Coupled to Scintillators With the Emission Maximum at 550 nm

A majority of the silicon photomultipliers (SiPMs) are sensitive to blue and near-ultraviolet (NUV) photons that are not optimized for scintillators with the emission maximum at wavelengths longer than 500 nm. The red–green–blue (RGB) SiPM is developed for the maximum photon detection efficiency (PDE) at 550 nm, which is a good match for some high-light-yield scintillators, such as CsI:Tl (CsI) and Gd 1.5 Y 1.5 Ga 2 Al 3 O 12 :Ce (GYGAG). Comparisons are made for the performance of these scintillators coupled to the RGB SiPM and a blue-sensitive SiPM. Because it takes tens of nanoseconds for the microcells to recharge after registering a photon hit, the linearity of these scintillation detectors was studied for high-energy gammas where numerous scintillation photons are generated. In addition, the energy resolution of the 662-keV gamma emitted by 137 Cs was measured for temperatures between –20 °C and 50 °C. The nonlinearity was observed above 1 MeV for all measurements, and however, it can be corrected by energy calibration using a third-degree polynomial. For CsI, the energy resolution is better with the blue-sensitive SiPM because of the lower dark count rate (DCR). In contrast, GYGAG coupled to the RGB SiPM has a better energy resolution for temperatures below 30 °C because of the well-matched emission spectrum and PDE distribution. Nevertheless, the advantage disappears for temperatures above 30 °C due to the higher DCR. It would be useful to further develop the RGB SiPM with a lower DCR and higher operating temperatures.

42 ENGINEERING↗

Conversion of mammographic images to appear with the noise and sharpness characteristics of a different detector and x-ray system

Purpose: Undertaking observer studies to compare imaging technology using clinical radiological images is challenging due to patient variability. To achieve a significant result, a large number of patients would be required to compare cancer detection rates for different image detectors and systems. The aim of this work was to create a methodology where only one set of images is collected on one particular imaging system. These images are then converted to appear as if they had been acquired on a different detector and x-ray system. Therefore, the effect of a wide range of digital detectors on cancer detection or diagnosis can be examined without the need for multiple patient exposures. Methods: Three detectors and x-ray systems [Hologic Selenia (ASE), GE Essential (CSI), Carestream CR (CR)] were characterized in terms of signal transfer properties, noise power spectra (NPS), modulation transfer function, and grid properties. The contributions of the three noise sources (electronic, quantum, and structure noise) to the NPS were calculated by fitting a quadratic polynomial at each spatial frequency of the NPS against air kerma. A methodology was developed to degrade the images to have the characteristics of a different (target) imaging system. The simulated images were created by first linearizing the original images such that the pixel values were equivalent to the air kerma incident at the detector. The linearized image was then blurred to match the sharpness characteristics of the target detector. Noise was then added to the blurred image to correct for differences between the detectors and any required change in dose. The electronic, quantum, and structure noise were added appropriate to the air kerma selected for the simulated image and thus ensuring that the noise in the simulated image had the same magnitude and correlation as the target image. A correction was also made for differences in primary grid transmission, scatter, and veiling glare. The method was validated by acquiring images of a CDMAM contrast detail test object (Artinis, The Netherlands) at five different doses for the three systems. The ASE CDMAM images were then converted to appear with the imaging characteristics of target CR and CSI detectors. Results: The measured threshold gold thicknesses of the simulated and target CDMAM images were closely matched at normal dose level and the average differences across the range of detail diameters were -4% and 0% for the CR and CSI systems, respectively. The conversion was successful for images acquired over a wide dose range. The average difference between simulated and target images for a given dose was a maximum of 11%. Conclusions: The validation shows that the image quality of a digital mammography image obtained with a particular system can be degraded, in terms of noise magnitude and color, sharpness, and contrast to account for differences in the detector and antiscatter grid. Potentially, this is a powerful tool for observer studies, as a range of image qualities can be examined by modifying an image set obtained at a single (better) image quality thus removing the patient variability when comparing systems.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Cone beam breast CT with a high pitch (75 μm), thick (500 μm) scintillator CMOS flat panel detector: Visibility of simulated microcalcifications

Purpose: To measure and investigate the improvement of microcalcification (MC) visibility in cone beam breast CT with a high pitch (75 μm), thick (500 μm) scintillator CMOS/CsI flat panel detector (Dexela 2923, Perkin Elmer).Methods: Aluminum wires and calcium carbonate grains of various sizes were embedded in a paraffin cylinder to simulate imaging of calcifications in a breast. Phantoms were imaged with a benchtop experimental cone beam CT system at various exposure levels. In addition to the Dexela detector, a high pitch (50 μm), thin (150 μm) scintillator CMOS/CsI flat panel detector (C7921CA-09, Hamamatsu Corporation, Hamamatsu City, Japan) and a widely used low pitch (194 μm), thick (600 μm) scintillator aSi/CsI flat panel detector (PaxScan 4030CB, Varian Medical Systems) were also used in scanning for comparison. The images were independently reviewed by six readers (imaging physicists). The MC visibility was quantified as the fraction of visible MCs and measured as a function of the estimated mean glandular dose (MGD) level for various MC sizes and detectors. The modulation transfer functions (MTFs) and detective quantum efficiencies (DQEs) were also measured and compared for the three detectors used.Results: The authors have demonstrated that the use of a high pitch (75 μm) CMOS detector coupled with a thick (500 μm) CsI scintillator helped make the smaller 150–160, 160–180, and 180–200 μm MC groups more visible at MGDs up to 10.8, 9, and 10.8 mGy, respectively. It also made the larger 200–212 and 212–224 μm MC groups more visible at MGDs up to 7.2 mGy. No performance improvement was observed for 224–250 μm or larger size groups. With the higher spatial resolution of the Dexela detector based system, the apparent dimensions and shapes of MCs were more accurately rendered. The results show that with the aforementioned detector, a 73% visibility could be achieved in imaging 160–180 μm MCs as compared to 28% visibility achieved by the low pitch (194 μm) aSi/CsI flat panel detector. The measurements confirm that the Hamamatsu detector has the highest MTF, followed by the Dexel detector, and then the Varian detector. However, the Dexela detector, with its thick (500 μm) CsI scintillator and low noise level, has the highest DQE at all frequencies, followed by the Varian detector, and then the Hamamatsu detector. The findings on the MC visibility correlated well with the differences in MTFs, noise power spectra, and DQEs measured for these three detectors.Conclusions: The authors have demonstrated that the use of the CMOS type Dexela detector with its high pitch (75 μm) and thick (500 μm) CsI scintillator could help improve the MC visibility. However, the improvement depended on the exposure level and the MC size. For imaging larger MCs or scanning at high exposure levels, there was little advantage in using the Dexela detector as compared to the aSi type Varian detector. These findings correlate well with the higher measured DQEs of the Dexela detector, especially at higher frequencies.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-P-02: Imaging and Radiation Oncology Core (IROC) Houston QA Center (RPC) Credentialing

Purpose: To provide information pertaining to IROC Houston QA Center's (RPC) credentialing process for institutions participating in NCI-sponsored clinical trials. Methods: IROC Houston issues credentials for NCI sponsored study groups. Requirements for credentialing might include any combination of questionnaires, knowledge assessment forms, benchmarks, or phantom irradiations. Credentialing requirements for specific protocols can be found on IROC Houston's website (irochouston.mdanderson.org). The website also houses the credentialing status inquiry (CSI) form. Once an institution has reviewed the protocol's credentialing requirements, a CSI form should be completed and submitted to IROC Houston. This form is used both to request whether requirements have been met as well as to notify IROC Houston that the institution requests credentialing for a specific protocol. IROC Houston will contact the institution to discuss any delinquent requirements. Once the institution has met all requirements IROC Houston issues a credentialing letter to the institution and will inform study groups and other IROC offices of the credentials. Institutions can all phone the IROC Houston office to initiate credentialing or ask any credentialing related questions. Results: Since 2010 IROC has received 1313 credentialing status inquiry forms. We received 317 in 2010, 266 in 2011, 324 in 2012, and 406 in 2013. On average we receive 35 phone calls per week with multiple types of credentialing questions. Decisions regarding credentialing status are based on the protocol specifications and previous completed credentialing by the institution. In some cases, such as for general IMRT credentialing, up to 5 sites may be credentialed based on the credentialing of one main center. Each of these situations is handled individually. Conclusion: IROC Houston will issue radiation therapy credentials for the NCI trials in the National Clinical Trials Network. Credentialing requirements and the CSI form can be found online at the IROC Houston's website. Work supported by PHS grant CA10953 and CA081647 (NCI, DHHS)

60 APPLIED LIFE SCIENCES↗

SU-E-T-197: Helical Cranial-Spinal Treatments with a Linear Accelerator

Purpose: Craniospinal irradiation (CSI) of systemic disease requires a high level of beam intensity modulation to reduce dose to bone marrow and other critical structures. Current helical delivery machines can take 30 minutes or more of beam-on time to complete these treatments. This pilot study aims to test the feasibility of performing helical treatments with a conventional linear accelerator using longitudinal couch travel during multiple gantry revolutions. Methods: The VMAT optimization package of the Eclipse 10.0 treatment planning system was used to optimize pseudo-helical CSI plans of 5 clinical patient scans. Each gantry revolution was divided into three 120° arcs with each isocenter shifted longitudinally. Treatments requiring more than the maximum 10 arcs used multiple plans with each plan after the first being optimized including the dose of the others (Figure 1). The beam pitch was varied between 0.2 and 0.9 (couch speed 5- 20cm/revolution and field width of 22cm) and dose-volume histograms of critical organs were compared to tomotherapy plans. Results: Viable pseudo-helical plans were achieved using Eclipse. Decreasing the pitch from 0.9 to 0.2 lowered the maximum lens dose by 40%, the mean bone marrow dose by 2.1% and the maximum esophagus dose by 17.5%. (Figure 2). Linac-based helical plans showed dose results comparable to tomotherapy delivery for both target coverage and critical organ sparing, with the D50 of bone marrow and esophagus respectively 12% and 31% lower in the helical linear accelerator plan (Figure 3). Total mean beam-on time for the linear accelerator plan was 8.3 minutes, 54% faster than the tomotherapy average for the same plans. Conclusions: This pilot study has demonstrated the feasibility of planning pseudo-helical treatments for CSI targets using a conventional linac and dynamic couch movement, and supports the ongoing development of true helical optimization and delivery.

60 APPLIED LIFE SCIENCES↗

SU-E-T-372: Dosimetric Comparison of Craniospinal Irradiation Using Different Tomotherapy Techniques

Purpose: TomoHDA can treat with fixed jaws, dynamic jaws, and fixed gantry using either 3DCRT or IMRT. This study compares PTV coverage, OAR sparing, and beam-on-time (BOT) among these techniques for craniospinal irradiation (CSI). Methods: This study includes ten CSI patients treated to 23.4 Gy/13 fractions with Hi-Art 3.0 unit (HT-IMRT fixed 5 cm jaw). New plans were regenerated with 5 cm jaw for TomoHDA Hi-Art 5.0 using dynamic jaw (HD-IMRT), TomoDirect-IMRT (TD-IMRT), and Helical Tomotherapy 3DCRT (HT-3DCRT using 5 cm and 2.5 cm jaws with various pitches). Studied parameters include PTV mean dose, D95 (dose covering 95% of PTV), Paddick's conformity index (CI) and homogeneity index (HI – standard deviation of PTV dose/average PTV dose), BOT, and average OAR doses. Results: PTV coverage from these techniques were comparable (p>0.05). The main differences were in OAR sparing; HDIMRT reduced more OAR doses for lenses, bladder and rectum compared to HT-IMRT. For the sparing of visceral organs: liver, lung, heart, and kidneys, the three IMRT techniques gave comparable results. HD-IMRT gave best heart sparing; HT-IMRT best kidney sparing. Liver and lung doses were best reduced by TD-IMRT. All three IMRT techniques gave comparable BOT. OARs sparing was achieved for jaw size of 2.5 cm. HI was also improved but with doubling of BOT. Increasing the pitch number from 0.2 to 0.43 produced no significant improvement in OAR sparing but CI and HI did improve. Conclusion: HT-3DCRT, HT-IMRT, HD-IMRT or TD-IMRT techniques give comparable PTV coverage but the three IMRT plans better spared OARs compared with 3DCRT plans. Dynamic jaw plan is superior to fixed jaw plan to spare more OAR doses at field edge. TD-IMRT cannot reduce BOT for CSI patient but for sparing certain OAR, TD-IMRT may be used to avoid the beam going through the structures of interest.

60 APPLIED LIFE SCIENCES↗

SU-E-T-621: Analysis of Robustness of Proton Pencil Beam Scanning Technique for Delivery of Craniospinal Irradiation

Purpose: To investigate the robustness and safety of craniospinal irradiation (CSI) planned with a proton pencil beam scanning (PBS) technique which overcomes the complexity of the planning associated with feathering match lines. Methods: Six CSI patients were planned with gradient-dose matching using PBS technique. Uniform dose coverage to the entire target volumes was achieved with averaged junction lengths of 6.9±0.3 cm. Robustness of the plans was evaluated by shifting the isocenter of each treatment field by ±3 mm in longitudinal direction and compared with the original non-shifted plan with metrics of conformity number (CN) and homogeneity index (HI). An anthropomorphic phantom study using film measurements was also carried out on a plan with 5 cm junction length. Results: For a given junction length, the dose errors were directly proportional to the setup errors. Setup errors of 3 mm from each field caused on average 3.5% lower CN and 2.1% higher HI. Minimal D95% to PTV and D98% to CTV were reduced by 2.2%±1.5% and 2.8%±1.7% respectively. A drop of maximal 6.8%±5.5% on the minimal dose to the cribriform plate was also observed. When the junction length was 5cm or longer, these 3mm setup errors from each field resulted in up to 12% dose errors. Consistent results were reached between film measurements and planned dose profiles in the junction area. Due to near-zero exit doses beyond the target volume, sparing of anterior organs such as heart, liver, lung and kidney were observed. Conclusions: Longitudinal setup errors directly reduce the dosimetric accuracy of the CSI treatment with matched proton fields. The reported technique creates a slow dose gradient in the junction area, which makes the treatment more robust and safe to longitudinal setup errors compared to conventional feathering methods.

60 APPLIED LIFE SCIENCES↗

SU-E-T-417: Experimental Verification of Robustness Optimized Intensity Modulated Proton Therapy Plans for Craniospinal Irradiation

Purpose: The robustness-optimized intensity modulated proton therapy (RO-IMPT) plans takes into account the setup errors to eliminate the hot/cold spots caused by setup errors at the junction for craniospinal (CSI) irradiation fields. The RO-IMPT requires a large area for the junction of two fields. This work is to verify the treatment planning system calculated dose with introduction of setup errors by two-dimensional (2D) dose measurement. Two fields of total lengths of 45 cm with junctions of 21 cm were measured. Methods: 2D dose distributions in the coronal plane were measured by a commercial 2D ion-chamber-array detector in a cubic solid water phantom. A total spine field consisting of an upper and a lower spine field was measured at the depths of 5.4 and 6.9 cm. The active area for the measurement was 24×24 cm{sup 2}2. The junction and the area outside the junction of the spine fields were measured separately to complete the verification for the total field. Six different amounts of set-up errors along the superior-inferior direction up to 1.4 cm were intentionally applied. The measured dose with and without set-up errors were compared with the calculated dose with and without set-up errors using Gamma-index analysis. 3%/3mm and 2%/2mm dose/distance agreement criteria were used. The point dose at the center of the junction was also compared. Results: For all fields with various introduced setup errors, 100 % of pixels passed the 3%/3mm criteria and on average 96% of pixels passed 2%/2mm criteria. Differences in the measured and calculated doses were within 1.1%. Conclusion: The efficacy of the robustness for the CSI RO-IMPT plans were verified by measurement. The measurement method can be used for patient treatment field specific QA for CSI RO-IMPT plans in our institution in the near future.

60 APPLIED LIFE SCIENCES↗