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At least 271 records · Page 15
All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

WE-A-17A-01: Absorbed Dose Rate-To-Water at the Surface of a Beta-Emitting Planar Ophthalmic Applicator with a Planar, Windowless Extrapolation Chamber

Purpose: Currently there is no primary calibration standard for determining the absorbed dose rate-to-water at the surface of β-emitting concave ophthalmic applicators and plaques. Machining tolerances involved in the design of concave window extrapolation chambers are a limiting factor for development of such a standard. Use of a windowless extrapolation chamber avoids these window-machining tolerance issues. As a windowless extrapolation chamber has never been attempted, this work focuses on proof of principle measurements with a planar, windowless extrapolation chamber to verify the accuracy in comparison to initial calibration, which could be extended to the design of a hemispherical, windowless extrapolation chamber. Methods: The window of an extrapolation chamber defines the electrical field, aids in aligning the source parallel to the collector-guard assembly, and decreases the backscatter due to attenuation of lower electron energy. To create a uniform and parallel electric field in this research, the source was made common to the collector-guard assembly. A precise positioning protocol was designed to enhance the parallelism of the source and collector-guard assembly. Additionally, MCNP5 was used to determine a backscatter correction factor to apply to the calibration. With these issues addressed, the absorbed dose rate-to-water of a Tracerlab 90Sr planar ophthalmic applicator was determined using National Institute of Standards and Technology's (NIST) calibration formalism, and the results of five trials with this source were compared to measurements at NIST with a traditional extrapolation chamber. Results: The absorbed dose rate-to-water of the planar applicator was determined to be 0.473 Gy/s ±0.6%. Comparing these results to NIST's determination of 0.474 Gy/s yields a −0.6% difference. Conclusion: The feasibility of a planar, windowless extrapolation chamber has been demonstrated. A similar principle will be applied to developing a primary calibration standard for concave applicators and plaques. This research is funded by the customers of the University of Wisconsin Accredited Dosimetry Calibration Laboratory.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

WE-G-18C-05: Characterization of Cross-Vendor, Cross-Field Strength MR Image Intensity Variations

Purpose: Variations in MR image intensity and image intensity nonuniformity (IINU) can challenge the accuracy of intensity-based image segmentation and registration algorithms commonly applied in radiotherapy. The goal of this work was to characterize MR image intensity variations across scanner vendors and field strengths commonly used in radiotherapy. Methods: ACR-MRI phantom images were acquired at 1.5T and 3.0T on GE (450w and 750, 23.1), Siemens (Espree and Verio, VB17B), and Philips (Ingenia, 4.1.3) scanners using commercial spin-echo sequences with matched parameters (TE/TR: 20/500 ms, rBW: 62.5 kHz, TH/skip: 5/5mm). Two radiofrequency (RF) coil combinations were used for each scanner: body coil alone, and combined body and phased-array head coils. Vendorspecific B1- corrections (PURE/Pre-Scan Normalize/CLEAR) were applied in all head coil cases. Images were transferred offline, corrected for IINU using the MNI N3 algorithm, and normalized. Coefficients of variation (CV=σ/μ) and peak image uniformity (PIU = 1−(Smax−Smin)/(Smax+Smin)) estimates were calculated for one homogeneous phantom slice. Kruskal-Wallis and Wilcoxon matched-pairs tests compared mean MR signal intensities and differences between original and N3 image CV and PIU. Results: Wide variations in both MR image intensity and IINU were observed across scanner vendors, field strengths, and RF coil configurations. Applying the MNI N3 correction for IINU resulted in significant improvements in both CV and PIU (p=0.0115, p=0.0235). However, wide variations in overall image intensity persisted, requiring image normalization to improve consistency across vendors, field strengths, and RF coils. These results indicate that B1- correction routines alone may be insufficient in compensating for IINU and image scaling, warranting additional corrections prior to use of MR images in radiotherapy. Conclusions: MR image intensities and IINU vary as a function of scanner vendor, field strength, and RF coil configuration. A two-step strategy consisting of MNI N3 correction followed by normalization was required to improve MR image consistency. Funding provided by Advancing a Healthier Wisconsin.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-A-BRF-11: Image Intensity Non-Uniformities Between MRI Simulation and Diagnostic MRI

Purpose: MRI simulation for MRI-based radiotherapy demands that patients be setup in treatment position, which frequently involves use of alternative radiofrequency (RF) coil configurations to accommodate immobilized patients. However, alternative RF coil geometries may exacerbate image intensity non-uniformities (IINU) beyond those observed in diagnostic MRI, which may challenge image segmentation and registration accuracy as well as confound studies assessing radiotherapy response when MR simulation images are used as baselines for evaluation. The goal of this work was to determine whether differences in IINU exist between MR simulation and diagnostic MR images. Methods: ACR-MRI phantom images were acquired at 3T using a spin-echo sequence (TE/TR:20/500ms, rBW:62.5kHz, TH/skip:5/5mm). MR simulation images were obtained by wrapping two flexible phased-array RF coils around the phantom. Diagnostic MR images were obtained by placing the phantom into a commercial phased-array head coil. Pre-scan normalization was enabled in both cases. Images were transferred offline and corrected for IINU using the MNI N3 algorithm. Coefficients of variation (CV=σ/μ) were calculated for each slice. Wilcoxon matched-pairs and Mann-Whitney tests compared CV values between original and N3 images and between MR simulation and diagnostic MR images. Results: Significant differences in CV were detected between original and N3 images in both MRI simulation and diagnostic MRI groups (p=0.010, p=0.010). In addition, significant differences in CV were detected between original MR simulation and original and N3 diagnostic MR images (p=0.0256, p=0.0016). However, no significant differences in CV were detected between N3 MR simulation images and original or N3 diagnostic MR images, demonstrating the importance of correcting MR simulation images beyond pre-scan normalization prior to use in radiotherapy. Conclusions: Alternative RF coil configurations used in MRI simulation can Result in significant IINU differences compared to diagnostic MR images. The MNI N3 algorithm reduced MR simulation IINU to levels observed in diagnostic MR images. Funding provided by Advancing a Healthier Wisconsin.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

MO-D-BRD-00: Electronic Brachytherapy

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

MO-D-BRD-01: Clinical Implementation of An Electronic Brachytherapy Program for the Skin

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

MO-D-BRD-02: Radiological Physics and Surface Lesion Treatments with Electronic Brachytherapy

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

MO-D-BRD-03: Radiobiology and Commissioning of Electronic Brachytherapy for IORT

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

MO-D-BRD-04: NIST Air-Kerma Standard for Electronic Brachytherapy Calibrations

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic brachytherapy and the various applications for which it is being used. To understand the physics of the calibration and commissioning for electronic brachytherapy sources To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-AB-204-00: Advances in Cone-Beam CT and Emerging Applications

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both the likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-AB-204-01: Advances in C-Arm CBCT for Brain Perfusion Imaging

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both the likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-AB-204-02: Advances in C-Arm CBCT for Cardiac Interventions

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both the likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-AB-204-03: Advances in CBCT for Orhtopaedics and Bone Health Imaging

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both the likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-AB-204-04: Advances in CBCT for Breast Imaging

This symposium highlights advanced cone-beam CT (CBCT) technologies in four areas of emerging application in diagnostic imaging and image-guided interventions. Each area includes research that extends the spatial, temporal, and/or contrast resolution characteristics of CBCT beyond conventional limits through advances in scanner technology, acquisition protocols, and 3D image reconstruction techniques. Dr. G. Chen (University of Wisconsin) will present on the topic: Advances in C-arm CBCT for Brain Perfusion Imaging. Stroke is a leading cause of death and disability, and a fraction of people having an acute ischemic stroke are suitable candidates for endovascular therapy. Critical factors that affect both the likelihood of successful revascularization and good clinical outcome are: 1) the time between stroke onset and revascularization; and 2) the ability to distinguish patients who have a small volume of irreversibly injured brain (ischemic core) and a large volume of ischemic but salvageable brain (penumbra) from patients with a large ischemic core and little or no penumbra. Therefore, “time is brain” in the care of the stroke patients. C-arm CBCT systems widely available in angiography suites have the potential to generate non-contrast-enhanced CBCT images to exclude the presence of hemorrhage, time-resolved CBCT angiography to evaluate the site of occlusion and collaterals, and CBCT perfusion parametric images to assess the extent of the ischemic core and penumbra, thereby fulfilling the imaging requirements of a “one-stop-shop” in the angiography suite to reduce the time between onset and revascularization therapy. The challenges and opportunities to advance CBCT technology to fully enable the one-stop-shop C-arm CBCT platform for brain imaging will be discussed. Dr. R. Fahrig (Stanford University) will present on the topic: Advances in C-arm CBCT for Cardiac Interventions. With the goal of providing functional information during cardiac interventions, significant effort has been expended to improve the quantitative accuracy of C-arm CBCT reconstructions. The challenge is to improve image quality while providing very short turnaround between data acquisition and volume data visualization. Corrections for x-ray scatter, view aliasing and patient motion that require no more than 2 iterations keep processing time short while reducing artifact. Fast, multi-sweep acquisitions can be used to permit assessment of left ventricular function, and visualization of radiofrequency lesions created to treat arrhythmias. Workflows for each imaging goal have been developed and validated against gold standard clinical CT or histology. The challenges, opportunities, and limitations of the new functional C-arm CBCT imaging techniques will be discussed. Dr. W. Zbijewski (Johns Hopkins University) will present on the topic: Advances in CBCT for Orthopaedics and Bone Health Imaging. Cone-beam CT is particularly well suited for imaging of musculoskeletal extremities. Owing to the high spatial resolution of flat-panel detectors, CBCT can surpass conventional CT in imaging tasks involving bone visualization, quantitative analysis of subchondral trabecular structure, and visualization and monitoring of subtle fractures that are common in orthopedic radiology. A dedicated CBCT platform has been developed that offers flexibility in system design and provides not only a compact configuration with improved logistics for extremities imaging but also enables novel diagnostic capabilities such as imaging of weight-bearing lower extremities in a natural stance. The design, development and clinical performance of dedicated extremities CBCT systems will be presented. Advanced capabilities for quantitative volumetric assessment of joint space morphology, dual-energy image-based quantification of bone composition, and in-vivo analysis of bone microarchitecture will be discussed, along with emerging applications in the diagnosis of arthritis and osteoporosis and assessment of novel therapies. Finally, Dr. J. Boone (UC Davis) will present on the topic: Advances in CBCT for Breast Imaging. Breast CT has been studied as an imaging tool for diagnostic breast evaluation and for potential breast cancer screening. The breast CT application lends itself to CBCT because of the small dimensions of the breast, the tapered shape of the breast towards higher cone angle, and the fact that there are no bones in the breast. The performance of various generations of breast CT scanners developed in recent years will be discussed, focusing on advances in spatial resolution and image noise characteristics. The results will also demonstrate the results of clinical trials using both computer and human observers. Learning Objectives: Understand the challenges, key technological advances, and emerging opportunities of CBCT in: Brain perfusion imaging, including assessment of ischemic stroke Cardiac imaging for functional assessment in cardiac interventions Orthopedics imaging for evaluation of musculoskeletal trauma, arthritis, and osteoporosis Breast imaging for screening and diagnosis of breast cancer. Work presented in this symposium includes research support by: Siemens Healthcare (Dr. Chen); NIH and Siemens Healthcare (Dr. Fahrig); NIH and Carestream Health (Dr. Zbijewski); and NIH (Dr. Boone)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-CD-304-10: Development and Optimization of “Compton Lens” Collimator Design for Increased Dose Rate in SRS

Purpose: To provide a proof of concept for a new collimator design to increase the dose rate at isocenter for stereotactic radiosurgery (SRS) treatments by taking advantage of off axis Compton scattered photons which are attenuated in current collimators. Methods: A fundamentally new collimator design was developed and optimized by introducing a series of slits to a standard block collimator. The introduction of slits allowed for initially off axis radiation that was scattered in the direction of the target to contribute to the target dose. For optimization, the design was broken into two parts: an upper interaction plate where primary scattering occurs, and a lower “Compton slit” region which allows for scattered photons traveling toward the target to reach isocenter. To optimize the design, a series of simulations were performed using MCNP6 in which several key parameters were adjusted and the output was compared to a standard collimator. Key parameters modified included the collimator material, cone size, and interaction plate thickness. The effects of using energies different than the traditional 6 MV beam were also explored. Results: An optimized collimator design utilizing a solid interaction plate with a Cesium-137 beam and a 4 mm cone size resulted in a dose rate increase on the order of 5% relative to standard collimators in use. Currently, designs incorporating a Cesium-137 source are the most feasible due to necessary size and weight concerns for 6 MV beams. Conclusion: Preliminary designs provide a proof of concept and indicate a potential to improve upon the dose rate of current collimators while not largely compromising the sharp dose falloff inherent to SRS. Further optimization into the geometry and positioning of the interaction plate, as well as slit optimization, will likely lead to further dose rate increases than were observed in this study. Funding for this work was provided by the Wisconsin Alumni Research Foundation (WARF). Authors have a conflict of interest as the technology discussed is patent pending, and thus there is a financial interest in the work.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-G-BRD-04: A Round Robin Dosimetry Intercomparison of Gamma Stereotactic Radiosurgery Calibration Protocols

Purpose: The purpose of this multi-institutional study was to compare two new gamma stereotactic radiosurgery (GSRS) dosimetry protocols to existing calibration methods. The ultimate goal was to guide AAPM Task Group 178 in recommending a standard GSRS dosimetry protocol. Methods: Nine centers (ten GSRS units) participated in the study. Each institution made eight sets of dose rate measurements: six with two different ionization chambers in three different 160mm-diameter spherical phantoms (ABS plastic, Solid Water and liquid water), and two using the same ionization chambers with a custom in-air positioning jig. Absolute dose rates were calculated using a newly proposed formalism by the IAEA working group for small and non-standard radiation fields and with a new air-kerma based protocol. The new IAEA protocol requires an in-water ionization chamber calibration and uses previously reported Monte-Carlo generated factors to account for the material composition of the phantom, the type of ionization chamber, and the unique GSRS beam configuration. Results obtained with the new dose calibration protocols were compared to dose rates determined by the AAPM TG-21 and TG-51 protocols, with TG-21 considered as the standard. Results: Averaged over all institutions, ionization chambers and phantoms, the mean dose rate determined with the new IAEA protocol relative to that determined with TG-21 in the ABS phantom was 1.000 with a standard deviation of 0.008. For TG-51, the average ratio was 0.991 with a standard deviation of 0.013, and for the new in-air formalism it was 1.008 with a standard deviation of 0.012. Conclusion: Average results with both of the new protocols agreed with TG-21 to within one standard deviation. TG-51, which does not take into account the unique GSRS beam configuration or phantom material, was not expected to perform as well as the new protocols. The new IAEA protocol showed remarkably good agreement with TG-21. Conflict of Interests: Paula Petti, Josef Novotny, Gennady Neyman and Steve Goetsch are consultants for Elekta Instrument A/B; Elekta Instrument AB, PTW Freiburg GmbH, Standard Imaging, Inc., and The Phantom Laboratory, Inc. loaned equipment for use in these experiments; The University of Wisconsin Accredited Dosimetry Calibration Laboratory provided calibration services.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-D-BRA-07: Analysis of ArcCHECK Diode Array Performance for ViewRay Quality Assurance

Purpose: Discrepancies in absolute dose values have been detected between the ViewRay treatment planning system and ArcCHECK readings when performing delivery quality assurance on the ViewRay system with the ArcCHECK-MR diode array (SunNuclear Corporation). In this work, we investigate whether these discrepancies are due to errors in the ViewRay planning and/or delivery system or due to errors in the ArcCHECK’s readings. Methods: Gamma analysis was performed on 19 ViewRay patient plans using the ArcCHECK. Frequency analysis on the dose differences was performed. To investigate whether discrepancies were due to measurement or delivery error, 10 diodes in low-gradient dose regions were chosen to compare with ion chamber measurements in a PMMA phantom with the same size and shape as the ArcCHECK, provided by SunNuclear. The diodes chosen all had significant discrepancies in absolute dose values compared to the ViewRay TPS. Absolute doses to PMMA were compared between the ViewRay TPS calculations, ArcCHECK measurements, and measurements in the PMMA phantom. Results: Three of the 19 patient plans had 3%/3mm gamma passing rates less than 95%, and ten of the 19 plans had 2%/2mm passing rates less than 95%. Frequency analysis implied a non-random error process. Out of the 10 diode locations measured, ion chamber measurements were all within 2.2% error relative to the TPS and had a mean error of 1.2%. ArcCHECK measurements ranged from 4.5% to over 15% error relative to the TPS and had a mean error of 8.0%. Conclusion: The ArcCHECK performs well for quality assurance on the ViewRay under most circumstances. However, under certain conditions the absolute dose readings are significantly higher compared to the planned doses. As the ion chamber measurements consistently agree with the TPS, it can be concluded that the discrepancies are due to ArcCHECK measurement error and not TPS or delivery system error. This work was funded by the Bhudatt Paliwal Professorship and the University of Wisconsin Medical Radiation Research Center.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-G-303-00: Nanotechnology for Imaging and Therapy

Over the last decade, there has been a growing interest in applying nanotechnology to cancer detection, treatment, and treatment monitoring. Advances in nanotechnology have enabled the fabrication of nanoparticles from various materials with different shapes and sizes. Nanoparticles can be accumulated preferentially within tumors by either “passive targeting” through a phenomenon typically known as “enhanced permeability and retention” or “active targeting” in which nanoparticles are conjugated with antibodies or peptides directed against tumor and/or stromal markers. The tumor specificity of nanoparticles in conjunction with their unique physicochemical properties offers many novel strategies for cancer treatment and detection. For example, notable approaches in the radiation oncology setting include the use of gold nanoparticles for radiation response modulation of tumor or normal tissue and thermal ablation or hyperthermia treatment of tumors. Some of these approaches are currently being tested either on humans or on animals and, very likely, will become the clinical reality in the near future. Various computational and experimental techniques have also been applied to address unique research issues associated with nanoparticles and may become the standard tools for future investigations and clinical translations. Therefore, both clinicians and researchers may need to be properly educated about the basic principles as well as the promise of nanoparticle-based applications with regard to the future of cancer diagnostics and therapeutics. This symposium will familiarize the audience with the potential applications of nanoparticles in oncologic imaging and therapy using specific illustrative examples. The audience will be properly oriented by these illustrative examples to the multiple avenues for collaborative research amongst interdisciplinary teams of physicists, clinicians, engineers, chemists, and biologists in industry and academia. Learning Objectives: Understand the physical bases of gold nanoparticle applications for radiosensitization and x-ray fluorescence imaging Understand the parameters that define gold nanoparticle-mediated radiosensitization in biological systems Understand the potential of magnetic nanoparticle characterization of the microenvironment Understand the various strategies for radiolabeling of nanoparticles and their applications S.C. and S.K. acknowledge support from MD Anderson Cancer Center, NIH (R01CA155446 and P30CA16672) and DoD (W81XWH-12-1-0198); J.W. acknowledges support from NIH (U54CA151662-01); W.C. acknowledges support from the University of Wisconsin-Madison, NIH (R01CA169365, P30CA014520, and T32CA009206), DoD (W81XWH-11-1-0644 and W81XWH-11-1-0648), and ACS (125246-RSG-13-099-01-CCE)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-G-303-01: Physical Bases for Gold Nanoparticle Applications in Radiation Oncology and X-Ray Imaging

Over the last decade, there has been a growing interest in applying nanotechnology to cancer detection, treatment, and treatment monitoring. Advances in nanotechnology have enabled the fabrication of nanoparticles from various materials with different shapes and sizes. Nanoparticles can be accumulated preferentially within tumors by either “passive targeting” through a phenomenon typically known as “enhanced permeability and retention” or “active targeting” in which nanoparticles are conjugated with antibodies or peptides directed against tumor and/or stromal markers. The tumor specificity of nanoparticles in conjunction with their unique physicochemical properties offers many novel strategies for cancer treatment and detection. For example, notable approaches in the radiation oncology setting include the use of gold nanoparticles for radiation response modulation of tumor or normal tissue and thermal ablation or hyperthermia treatment of tumors. Some of these approaches are currently being tested either on humans or on animals and, very likely, will become the clinical reality in the near future. Various computational and experimental techniques have also been applied to address unique research issues associated with nanoparticles and may become the standard tools for future investigations and clinical translations. Therefore, both clinicians and researchers may need to be properly educated about the basic principles as well as the promise of nanoparticle-based applications with regard to the future of cancer diagnostics and therapeutics. This symposium will familiarize the audience with the potential applications of nanoparticles in oncologic imaging and therapy using specific illustrative examples. The audience will be properly oriented by these illustrative examples to the multiple avenues for collaborative research amongst interdisciplinary teams of physicists, clinicians, engineers, chemists, and biologists in industry and academia. Learning Objectives: Understand the physical bases of gold nanoparticle applications for radiosensitization and x-ray fluorescence imaging Understand the parameters that define gold nanoparticle-mediated radiosensitization in biological systems Understand the potential of magnetic nanoparticle characterization of the microenvironment Understand the various strategies for radiolabeling of nanoparticles and their applications S.C. and S.K. acknowledge support from MD Anderson Cancer Center, NIH (R01CA155446 and P30CA16672) and DoD (W81XWH-12-1-0198); J.W. acknowledges support from NIH (U54CA151662-01); W.C. acknowledges support from the University of Wisconsin-Madison, NIH (R01CA169365, P30CA014520, and T32CA009206), DoD (W81XWH-11-1-0644 and W81XWH-11-1-0648), and ACS (125246-RSG-13-099-01-CCE)

60 APPLIED LIFE SCIENCES↗