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Using 3D Measurements from MRI to Improve VVUQ

Magnetic resonance velocimetry (MRV) is a diagnostic that can measure 3D, three-component turbulent velocity fields in arbitrarily complex flow configurations. The approach uses magnetic resonance imaging (MRI), which is a system commonly available in radiology departments or medical research centers. MRV acquires signal from hydrogen protons in water channel flows. Despite the obvious utility of the measurements for investigating a variety of flows, comparisons with computational fluid dynamic (CFD) simulations largely retain traditional metrics, comparing velocity profiles and planes at discrete regions within the flow rather than using the 3D nature of the measured field. In this effort, MRV was conducted in a simple water channel with six spanwise-centered periodic obstacles roughly shaped as cubes. At a fully turbulent Reynolds number of 15,000, the channel includes two flows: a main streamwise flow and, in the wake of the second obstacle, an injected flow oriented perpendicular to the streamwise flow. The flow geometry includes partial obstacles on the side walls and is inherently 3D because of the interaction of the two streams and the wake features, making the flow challenging to completely measure with traditional optical techniques. Aside from line profiles and planar comparisons, two 3D metrics are used to compare the data with a steady Reynolds-averaged Navier–Stokes (RANS) simulation result. A brief discussion about the comparison is provided, including comments about uncertainty.

Benson, Mike [ORNL] (ORCID:000000023210116X)↗

Tumor response parameters for head and neck cancer derived from tumor-volume variation during radiation therapy

Purpose: The main goal of this paper is to reconstruct a distribution of cell survival fractions from tumor-volume variation for a heterogeneous group of head and neck cancer patients and compare this distribution to the data from predictive assays. Methods: To characterize the tumor-volume variation during radiation therapy treatment, the authors use a two-level tumor-volume model of cell population that separates the entire tumor cell population into two subpopulations of viable cells and lethally damaged cells. This parameterized radiobiological model is integrated with a least squares objective function and a simulated annealing optimization algorithm to describe time-dependent tumor-volume variation rates in individual patients. Several constraints have been used in the optimization problem because tumor-volume variation during radiotherapy is described by a sum of exponentials; therefore, the problem of accurately fitting a model to measured data is ill-posed. The model was applied to measured tumor-volume variation curves from a clinical study on tumor-volume variation during radiotherapy for 14 head and neck cancer patients in which an integrated CT/linear particle accelerator (LINAC) system was used for tumor-volume measurements. Results: The two-level cell population tumor-volume modeling is capable of describing tumor-volume variation throughout the entire treatment for 11 of the 14 patients. For three patients, the tumor-volume variation was described only during the initial part of treatment, a fact that may be related to the neglected hypoxia in the two-level approximation. The predicted probability density distribution for the survival fractions agrees with the data obtained using in vitro studies with predictive assays. The mean value 0.35 of survival fraction obtained in this study is larger than the value 0.32 from in vitro studies, which could be expected because of greater repair in vivo. The mean half-life obtained in this study for the head-and-neck squamous cell carcinoma (SCC) is equal to 3.8 mean potential doubling times, which agrees with 4.0 mean potential doubling times obtained previously for lung SCC. Conclusions: The distribution of cell survival fractions obtained in this study support the hypothesis that the tumor-volume variation during radiotherapy treatment for head and neck cancer can be described by the two-level cell population tumor-volume model. This model can be used for in vivo evaluation of patient-specific radiobiological parameters that are needed for tumor-control probability evaluation.

60 APPLIED LIFE SCIENCES↗

NaroNet: Discovery of tumor microenvironment elements from highly multiplexed images

Understanding the spatial interactions between the elements of the tumor microenvironment -i.e. tumor cells. fibroblasts, immune cells- and how these interactions relate to the diagnosis or prognosis of a tumor is one of the goals of computational pathology. We present NaroNet, a deep learning framework that models the multi-scale tumor microenvironment from multiplex-stained cancer tissue images and provides patient-level interpretable predictions using a seamless end-to-end learning pipeline. Trained only with multiplex-stained tissue images and their corresponding patient-level clinical labels, NaroNet unsupervisedly learns which cell phenotypes, cell neighborhoods, and neighborhood interactions have the highest influence to predict the correct label. To this end, NaroNet incorporates several novel and state-of-the-art deep learning techniques, such as patch-level contrastive learning, multi-level graph embeddings, a novel max-sum pooling operation, or a metric that quantifies the relevance that each microenvironment element has in the individual predictions. We validate NaroNet using synthetic data simulating multiplex-immunostained images where a patient label is artificially associated to the -adjustable- probabilistic incidence of different microenvironment elements. We then apply our model to two sets of images of human cancer tissues: 336 seven-color multiplex-immunostained images from 12 high-grade endometrial cancer patients; and 382 35-plex mass cytometry images from 215 breast cancer patients. In both synthetic and real datasets, NaroNet provides outstanding predictions of relevant clinical information while associating those predictions to the presence of specific microenvironment elements.

60 APPLIED LIFE SCIENCES↗

MO-G-17A-02: Computer Simulation Studies for On-Board Functional and Molecular Imaging of the Prostate Using a Robotic Multi-Pinhole SPECT System

Purpose: To investigate prostate imaging onboard radiation therapy machines using a novel robotic, 49-pinhole Single Photon Emission Computed Tomography (SPECT) system. Methods: Computer-simulation studies were performed for region-of-interest (ROI) imaging using a 49-pinhole SPECT collimator and for broad cross-section imaging using a parallel-hole SPECT collimator. A male XCAT phantom was computersimulated in supine position with one 12mm-diameter tumor added in the prostate. A treatment couch was added to the phantom. Four-minute detector trajectories for imaging a 7cm-diameter-sphere ROI encompassing the tumor were investigated with different parameters, including pinhole focal length, pinhole diameter and trajectory starting angle. Pseudo-random Poisson noise was included in the simulated projection data, and SPECT images were reconstructed by OSEM with 4 subsets and up to 10 iterations. Images were evaluated by visual inspection, profiles, and Root-Mean- Square-Error (RMSE). Results: The tumor was well visualized above background by the 49-pinhole SPECT system with different pinhole parameters while it was not visible with parallel-hole SPECT imaging. Minimum RMSEs were 0.30 for 49-pinhole imaging and 0.41 for parallelhole imaging. For parallel-hole imaging, the detector trajectory from rightto- left yielded slightly lower RMSEs than that from posterior to anterior. For 49-pinhole imaging, near-minimum RMSEs were maintained over a broader range of OSEM iterations with a 5mm pinhole diameter and 21cm focal length versus a 2mm diameter pinhole and 18cm focal length. The detector with 21cm pinhole focal length had the shortest rotation radius averaged over the trajectory. Conclusion: On-board functional and molecular prostate imaging may be feasible in 4-minute scan times by robotic SPECT. A 49-pinhole SPECT system could improve such imaging as compared to broadcross-section parallel-hole collimated SPECT imaging. Multi-pinhole imaging can be improved by considering pinhole focal length, pinhole diameter, and trajectory starting angle. The project is supported by the NIH grant 5R21-CA156390.

60 APPLIED LIFE SCIENCES↗

Response of LiF:Mg,Ti thermoluminescent dosimeters at photon energies relevant to the dosimetry of brachytherapy (<1 MeV)

Purpose: High energy photon beams are used in calibrating dosimeters for use in brachytherapy since absorbed dose to water can be determined accurately and with traceability to primary standards in such beams, using calibrated ion chambers and standard dosimetry protocols. For use in brachytherapy, beam quality correction factors are needed, which include corrections for differences in mass energy absorption properties between water and detector as well as variations in detector response (intrinsic efficiency) with radiation quality, caused by variations in the density of ionization (linear energy transfer (LET) -distributions) along the secondary electron tracks. The aim of this work was to investigate experimentally the detector response of LiF:Mg,Ti thermoluminescent dosimeters (TLD) for photon energies below 1 MeV relative to {sup 60}Co and to address discrepancies between the results found in recent publications of detector response. Methods: LiF:Mg,Ti dosimeters of formulation MTS-N Poland were irradiated to known values of air kerma free-in-air in x-ray beams at tube voltages 25-250 kV, in {sup 137}Cs- and {sup 60}Co-beams at the Swedish Secondary Standards Dosimetry Laboratory. Conversions from air kerma free-in-air into values of mean absorbed dose in the dosimeters in the actual irradiation geometries were made using EGSnrc Monte Carlo simulations. X-ray energy spectra were measured or calculated for the actual beams. Detector response relative to that for {sup 60}Co was determined at each beam quality. Results: An increase in relative response was seen for all beam qualities ranging from 8% at tube voltage 25 kV (effective energy 13 keV) to 3%-4% at 250 kV (122 keV effective energy) and {sup 137}Cs with a minimum at 80 keV effective energy (tube voltage 180 kV). The variation with effective energy was similar to that reported by Davis et al.[Radiat. Prot. Dosim. 106, 33-43 (2003)] with our values being systematically lower by 2%-4%. Compared to the results by Nunn et al.[Med. Phys. 35, 1861-1869 (2008)], the relative detector response as a function of effective energy differed in both shape and magnitude. This could be explained by the higher maximum read-out temperature (350 deg. C) used by Nunn et al.[Med. Phys. 35, 1861-1869 (2008)], allowing light emitted from high-temperature peaks with a strong LET dependence to be registered. Use of TLD-100 by Davis et al.[Radiat. Prot. Dosim. 106, 33-43 (2003)] with a stronger super-linear dose response compared to MTS-N was identified as causing the lower relative detector response in this work. Conclusions: Both careful dosimetry and strict protocols for handling the TLDs are required to reach solid experimental data on relative detector response. This work confirms older findings that an over-response relative to {sup 60}Co exists for photon energies below 200-300 keV. Comparison with the results from the literature indicates that using similar protocols for annealing and read-out, dosimeters of different makes (TLD-100, MTS-N) differ in relative detector response. Though universality of the results has not been proven and further investigation is needed, it is anticipated that with the use of strict protocols for annealing and read-out, it will be possible to determine correction factors that can be used to reduce uncertainties in dose measurements around brachytherapy sources at photon energies where primary standards for absorbed dose to water are not available.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Role of belly board device in the age of intensity modulated radiotherapy for pelvic irradiation

Small bowel dose often represents a limiting factor for radiation treatment of pelvic malignancies. To reduce small bowel toxicity, a belly board device (BBD) with a prone position is often recommended. Intensity modulated radiotherapy (IMRT) could reduce dose to small bowel based on the desired dose-volume constraints. We investigated the efficacy of BBD in conjunction with IMRT. A total of 11 consecutive patients with the diagnosis of rectal cancer, who were candidates for definitive therapy, were selected. Patients were immobilized with BBD in prone position for simulation and treatment. Supine position computed tomography (CT) data were either acquired at the same time or during a diagnostic scan, and if existed was used. Target volumes (TV) as well as organs at risk (OAR) were delineated in both studies. Three-dimensional conformal treatment (3DCRT) and IMRT plans were made for both scans. Thus for each patient, 4 plans were generated. Statistical analysis was conducted for maximum, minimum, and mean dose to each structure. When comparing the normalized mean Gross TV dose for the different plans, there was no statistical difference found between the planning types. There was a significant difference in small bowel sparing when using prone position on BBD comparing 3DCRT and IMRT plans, favoring IMRT with a 29.6% reduction in dose (p = 0.007). There was also a statistically significant difference in small bowel sparing when comparing supine position IMRT to prone-BBD IMRT favoring prone-BBD IMRT with a reduction of 30.3% (p = 0.002). For rectal cancer when small bowel could be a limiting factor, prone position using BBD along with IMRT provides the best sparing. We conclude that whenever a dose escalation in rectal cancer is desired where small bowel could be limiting factor, IMRT in conjunction with BBD should be selected.

61 RADIATION PROTECTION AND DOSIMETRY↗

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

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

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Enhanced detection of paramagnetic fluorine-19 magnetic resonance imaging agents using zero echo time sequence and compressed sensing

Fluorine-19 ( 19 F) magnetic resonance imaging (MRI) is an emerging technique offering specific detection of labeled cells in vivo. Lengthy acquisition times and modest signal-to-noise ratio (SNR) makes three-dimensional spin-density–weighted 19 F imaging challenging. Recent advances in tracer paramagnetic metallo-perfluorocarbon (MPFC) nanoemulsion probes have shown multifold SNR improvements due to an accelerated 19 F T 1 relaxation rate and a commensurate gain in imaging speed and averages. However, 19 F T 2 -reduction and increased linewidth limit the amount of metal additive in MPFC probes, thus constraining the ultimate SNR. To overcome these barriers, we describe a compressed sampling (CS) scheme, implemented using a “zero” echo time (ZTE) sequence, with data reconstructed via a sparsity-promoting algorithm. Our CS-ZTE scheme acquires k-space data using an undersampled spherical radial pattern and signal averaging. Image reconstruction employs off-the-shelf sparse solvers to solve a joint total variation and -norm regularized least square problem. To evaluate CS-ZTE, we performed simulations and acquired 19 F MRI data at 11.7 T in phantoms and mice receiving MPFC-labeled dendritic cells. For MPFC-labeled cells in vivo, we show SNR gains of ~6.3 × with 8-fold undersampling. We show that this enhancement is due to three mechanisms including undersampling and commensurate increase in signal averaging in a fixed scan time, denoising attributes from the CS algorithm, and paramagnetic reduction of T 1 . Importantly, 19 F image intensity analyses yield accurate estimates of absolute quantification of 19 F spins. Overall, the CS-ZTE method using MPFC probes achieves ultrafast imaging, a substantial boost in detection sensitivity, accurate 19 F spin quantification, and minimal image artifacts.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Potential of dual-energy subtraction for converting CT numbers to electron density based on a single linear relationship

Purpose: The conversion of the computed tomography (CT) number to electron density is one of the main processes that determine the accuracy of patient dose calculations in radiotherapy treatment planning. However, the CT number and electron density of tissues cannot be generally interrelated via a simple one-to-one correspondence because the CT number depends on the effective atomic number as well as the electron density. The purpose of this study is to present a simple conversion from the energy-subtracted CT number ({Delta}HU) by means of dual-energy CT (DECT) to the relative electron density ({rho}{sub e}) via a single linear relationship. Methods: The {Delta}HU-{rho}{sub e} conversion method was demonstrated by performing analytical DECT image simulations that were intended to imitate a second-generation dual-source CT (DSCT) scanner with an additional tin filtration for the high-kV tube. The {Delta}HU-{rho}{sub e} calibration line was obtained from the image simulation with a 33 cm-diameter electron density calibration phantom equipped with 16 inserts including polytetrafluoroethylene, polyvinyl chloride, and aluminum; the elemental compositions of these three inserts were quite different to those of body tissues. The {Delta}HU-{rho}{sub e} conversion method was also applied to previously published experimental CT data, which were measured using two different CT scanners, to validate the clinical feasibility of the present approach. In addition, the effect of object size on {rho}{sub e}-calibrated images was investigated by image simulations using a 25 cm-diameter virtual phantom for two different filtrations: with and without the tin filter for the high-kV tube. Results: The simulated {Delta}HU-{rho}{sub e} plot exhibited a predictable linear relationship over a wide range of {rho}{sub e} from 0.00 (air) to 2.35 (aluminum). Resultant values of the coefficient of determination, slope, and intercept of the linear function fitted to the data were close to those of the ideal case. The maximum difference between the ideal and simulated {rho}{sub e} values was -0.7%. The satisfactory linearity of {Delta}HU-{rho}{sub e} was also confirmed from analyses of the experimental CT data. In the experimental cases, the maximum difference between the nominal and simulated {rho}{sub e} values was found to be 2.5% after two outliers were excluded. When compared with the case without the tin filter, the {Delta}HU-{rho}{sub e} conversion performed with the tin filter yielded a lower dose and more reliable {rho}{sub e} values that were less affected by the object-size variation. Conclusions: The {Delta}HU-{rho}{sub e} calibration line with a simple one-to-one correspondence would facilitate the construction of a well-calibrated {rho}{sub e} image from acquired dual-kV images, and currently, second generation DSCT may be a feasible modality for the clinical use of the {Delta}HU-{rho}{sub e} conversion method.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Onboard functional and molecular imaging: A design investigation for robotic multipinhole SPECT

Purpose: Onboard imaging—currently performed primarily by x-ray transmission modalities—is essential in modern radiation therapy. As radiation therapy moves toward personalized medicine, molecular imaging, which views individual gene expression, may also be important onboard. Nuclear medicine methods, such as single photon emission computed tomography (SPECT), are premier modalities for molecular imaging. The purpose of this study is to investigate a robotic multipinhole approach to onboard SPECT. Methods: Computer-aided design (CAD) studies were performed to assess the feasibility of maneuvering a robotic SPECT system about a patient in position for radiation therapy. In order to obtain fast, high-quality SPECT images, a 49-pinhole SPECT camera was designed which provides high sensitivity to photons emitted from an imaging region of interest. This multipinhole system was investigated by computer-simulation studies. Seventeen hot spots 10 and 7 mm in diameter were placed in the breast region of a supine female phantom. Hot spot activity concentration was six times that of background. For the 49-pinhole camera and a reference, more conventional, broad field-of-view (FOV) SPECT system, projection data were computer simulated for 4-min scans and SPECT images were reconstructed. Hot-spot localization was evaluated using a nonprewhitening forced-choice numerical observer. Results: The CAD simulation studies found that robots could maneuver SPECT cameras about patients in position for radiation therapy. In the imaging studies, most hot spots were apparent in the 49-pinhole images. Average localization errors for 10-mm- and 7-mm-diameter hot spots were 0.4 and 1.7 mm, respectively, for the 49-pinhole system, and 3.1 and 5.7 mm, respectively, for the reference broad-FOV system. Conclusions: A robot could maneuver a multipinhole SPECT system about a patient in position for radiation therapy. The system could provide onboard functional and molecular imaging with 4-min scan times.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Species Transport Framework Development in SAM for System-Level Tritium Source Term Analysis

The SAM code is under development as a modern system-level modeling and simulation tool for advanced non–light water reactor safety analyses, with recent efforts to add capabilities to evaluate radiological source term risks in these novel reactor concepts. By leveraging the established system-level multiphysics thermal-hydraulic models in SAM, a framework for tightly coupled species transport modeling has been integrated into the code for engineering-scale source term evaluation. This species transport framework was first applied to the simulation of tritium, which is a well-known source term in conventional light water reactors. Tritium poses a unique risk in salt-cooled reactors, especially those with lithium-bearing salts such as the fluoride salt–cooled high-temperature reactor (FHR) concept, as tritium is generated in the salt coolant in significant quantities due to neutron interactions. A compounding factor is the increased mobility of tritium at high temperatures, which is able to permeate through metals while also potentially being retained in graphite pebbles and structures. Engineering-scale models for the tritium transport pathways in a FHR have been developed using the new species transport framework in SAM. The capabilities are assessed through analytical verification problems and validated with data from a graphite retention experiment. In conclusion, the system-level model is demonstrated by performing an initial estimate of baseline tritium generation and flows in a generic reference SAM FHR model, setting a foundation for future studies of source term transient analysis with the potential for further multiscale and multiphysics integration.

SAM↗

Segmentation-free empirical beam hardening correction for CT

Purpose: The polychromatic nature of the x-ray beams and their effects on the reconstructed image are often disregarded during standard image reconstruction. This leads to cupping and beam hardening artifacts inside the reconstructed volume. To correct for a general cupping, methods like water precorrection exist. They correct the hardening of the spectrum during the penetration of the measured object only for the major tissue class. In contrast, more complex artifacts like streaks between dense objects need other techniques of correction. If using only the information of one single energy scan, there are two types of corrections. The first one is a physical approach. Thereby, artifacts can be reproduced and corrected within the original reconstruction by using assumptions in a polychromatic forward projector. These assumptions could be the used spectrum, the detector response, the physical attenuation and scatter properties of the intersected materials. A second method is an empirical approach, which does not rely on much prior knowledge. This so-called empirical beam hardening correction (EBHC) and the previously mentioned physical-based technique are both relying on a segmentation of the present tissues inside the patient. The difficulty thereby is that beam hardening by itself, scatter, and other effects, which diminish the image quality also disturb the correct tissue classification and thereby reduce the accuracy of the two known classes of correction techniques. The herein proposed method works similar to the empirical beam hardening correction but does not require a tissue segmentation and therefore shows improvements on image data, which are highly degraded by noise and artifacts. Furthermore, the new algorithm is designed in a way that no additional calibration or parameter fitting is needed. Methods: To overcome the segmentation of tissues, the authors propose a histogram deformation of their primary reconstructed CT image. This step is essential for the proposed algorithm to be segmentation-free (sf). This deformation leads to a nonlinear accentuation of higher CT-values. The original volume and the gray value deformed volume are monochromatically forward projected. The two projection sets are then monomially combined and reconstructed to generate sets of basis volumes which are used for correction. This is done by maximization of the image flatness due to adding additionally a weighted sum of these basis images. sfEBHC is evaluated on polychromatic simulations, phantom measurements, and patient data. The raw data sets were acquired by a dual source spiral CT scanner, a digital volume tomograph, and a dual source micro CT. Different phantom and patient data were used to illustrate the performance and wide range of usability of sfEBHC across different scanning scenarios. The artifact correction capabilities are compared to EBHC. Results: All investigated cases show equal or improved image quality compared to the standard EBHC approach. The artifact correction is capable of correcting beam hardening artifacts for different scan parameters and scan scenarios. Conclusions: sfEBHC generates beam hardening-reduced images and is furthermore capable of dealing with images which are affected by high noise and strong artifacts. The algorithm can be used to recover structures which are hardly visible inside the beam hardening-affected regions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SISTec: Mathematical Calibration of Large Clearance Monitors - 18265

One major path for clearance of large amount of waste arising from the decommission of nuclear power plants is based on measurement with large clearance monitors (also known as free release measurement facilities). These devices utilize multi-detector plastic scintillator arrays (large clearance monitors can consist of up to 24 plastic scintillators) to offer both, extremely low minimum detectable activities (MDA) and short measurement times for waste packages weighing up to one metric ton. However, a major problem with these devices is to obtain nuclide specific efficiencies, especially for geometrically complex large waste packages. Normal procedure for estimating the efficiency is to device dummy waste packages and attach point sources with well-known activities to unfavourable positions in these packages. In accordance with this procedure, calibration factors can be derived in a radiological conservative way. Devising such test dummies is not always possible and the procedure is prone to generating large measurement uncertainties. In this publication, we propose a new method to derive calibration factors by means of the Los Alamos National Laboratory (LANL) simulation tool Monte Carlo N-Particle (MCNP) and a statistical-phenomenological model for the detector characterization. In a multi-step approach, first the detector response for a distribution of activity in a waste package is calculated and subsequently the detectors are mathematically characterized. Applying state of the art statistical and optimizing procedures, parameters for the detector response are derived in a self-consistent way. This also allows to rigorously propagate the uncertainties to the final calculated calibration factors according to the Guide to the Expression of Uncertainty in Measurement (GUM supplement 1). To validate the derived parameters for the detector characterization a minimally invasive experimental setup was devised and installed into the large clearance monitor. It consisted of an aluminum swivel arm which could position point sources to the relevant coordinates. The so collected measurement data not only allowed to investigate the precision of the calculated calibration factors, but also to probe the location of concentrated activity sources in the waste package. Furthermore, data on measurements with dummy waste packages were collected to test the reproducibility of well-known calibration factors. We present the software tool SIStec, which will provide an intuitive user-interface to generate and simulate waste package models and execute the above-mentioned method. Using SIStec, different scenarios for the distribution of activity in the waste package can be probed. This will also allow to optimize the clearance process on various levels. For example, measurement time for pre-measurements can be reduced in exchange for unfavourable calibration factors, which would still allow to meet the regulator limits for clearance. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

Development of 5- and 10-year-old pediatric phantoms based on polygon mesh surfaces

Purpose: The purpose of this study is the development of reference pediatric phantoms for 5- and 10-year-old children to be used for the calculation of organ and tissue equivalent doses in radiation protection. Methods: The study proposes a method for developing anatomically highly sophisticated pediatric phantoms without using medical images. The 5- and 10-year-old male and female phantoms presented here were developed using 3D modeling software applied to anatomical information taken from atlases and textbooks. The method uses polygon mesh surfaces to model body contours, the shape of organs as well as their positions, and orientations in the human body. Organ and tissue masses comply with the corresponding data given by the International Commission on Radiological Protection (ICRP) for the 5- and 10-year-old reference children. Bones were segmented into cortical bone, spongiosa, medullary marrow, and cartilage to allow for the use of micro computer tomographic ({mu}CT) images of trabecular bone for skeletal dosimetry. Results: The four phantoms, a male and a female for each age, and their organs are presented in 3D images and their organ and tissue masses in tables which show the compliance of the ICRP reference values. Dosimetric data, calculated for the reference pediatric phantoms by Monte Carlo methods were compared with corresponding data from adult mesh phantoms and pediatric stylized phantoms. The comparisons show reasonable agreement if the anatomical differences between the phantoms are properly taken into account. Conclusions: Pediatric phantoms were developed without using medical images of patients or volunteers for the first time. The models are reference phantoms, suitable for regulatory dosimetry, however, the 3D modeling method can also be applied to medical images to develop patient-specific phantoms.

61 RADIATION PROTECTION AND DOSIMETRY↗

Brain necrosis after fractionated radiation therapy: Is the halftime for repair longer than we thought?

Purpose: To derive a radiobiological model that enables the estimation of brain necrosis and spinal cord myelopathy rates for a variety of fractionation schemes, and to compare repair effects between brain and spinal cord. Methods: Sigmoidal dose response relationships for brain radiation necrosis and spinal cord myelopathy are derived from clinical data using nonlinear regression. Three different repair models are considered and the repair halftimes are included as regression parameters. Results: For radiation necrosis, a repair halftime of 38.1 (range 6.9-76) h is found with monoexponential repair, while for spinal cord myelopathy, a repair halftime of 4.1 (range 0-8) h is found. The best-fit alpha beta ratio is 0.96 (range 0.24-1.73)Conclusions: A radiobiological model that includes repair corrections can describe the clinical data for a variety of fraction sizes, fractionation schedules, and total doses. Modeling suggests a relatively long repair halftime for brain necrosis. This study suggests that the repair halftime for late radiation effects in the brain may be longer than is currently thought. If confirmed in future studies, this may lead to a re-evaluation of radiation fractionation schedules for some CNS diseases, particularly for those diseases where fractionated stereotactic radiation therapy is used.

60 APPLIED LIFE SCIENCES↗

The influence of respiratory motion on CT image volume definition

Purpose: Radiotherapy treatments are based on geometric and density information acquired from patient CT scans. It is well established that breathing motion during scan acquisition induces motion artifacts in CT images, which can alter the size, shape, and density of a patient's anatomy. The aim of this work is to examine and evaluate the impact of breathing motion on multislice CT imaging with respiratory synchronization (4DCT) and without it (3DCT). Methods: A specific phantom with a movable insert was used. Static and dynamic phantom acquisitions were obtained with a multislice CT. Four sinusoidal breath patterns were simulated to move known geometric structures longitudinally. Respiratory synchronized acquisitions (4DCT) were performed to generate images during inhale, intermediate, and exhale phases using prospective and retrospective techniques. Static phantom data were acquired in helical and sequential mode to define a baseline for each type of respiratory 4DCT technique. Taking into account the fact that respiratory 4DCT is not always available, 3DCT helical image studies were also acquired for several CT rotation periods. To study breath and acquisition coupling when respiratory 4DCT was not performed, the beginning of the CT image acquisition was matched with inhale, intermediate, or exhale respiratory phases, for each breath pattern. Other coupling scenarios were evaluated by simulating different phantom and CT acquisition parameters. Motion induced variations in shape and density were quantified by automatic threshold volume generation and Dice similarity coefficient calculation. The structure mass center positions were also determined to make a comparison with their theoretical expected position. Results: 4DCT acquisitions provided volume and position accuracies within ±3% and ±2 mm for structure dimensions >2 cm, breath amplitude ≤15 mm, and breath period ≥3 s. The smallest object (1 cm diameter) exceeded 5% volume variation for the breath patterns of higher frequency and amplitude motion. Larger volume differences (>10%) and inconsistencies between the relative positions of objects were detected in image studies acquired without respiratory control. Increasing the 3DCT rotation period caused a higher distortion in structures without obtaining their envelope. Simulated data showed that the slice acquisition time should be at least twice the breath period to average object movement. Conclusions: Respiratory 4DCT images provide accurate volume and position of organs affected by breath motion detecting higher volume discrepancies as amplitude length or breath frequency are increased. For 3DCT acquisitions, a CT should be considered slow enough to include lesion envelope as long as the slice acquisition time exceeds twice the breathing period. If this requirement cannot be satisfied, a fast CT (along with breath-hold inhale and exhale CTs to estimate roughly the ITV) is recommended in order to minimize structure distortion. Even with an awareness of a patient's respiratory cycle, its coupling with 3DCT acquisition cannot be predicted since patient anatomy is not accurately known.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Robustness Against Interfraction Prostate Movement in Scanned Ion Beam Radiation Therapy

Purpose: To assess the robustness of scanned ion beam treatment plans against the interfraction internal target motion and evaluate the limits of validity of target-based isocenter realignment for prostate cancer radiation therapy. Methods and Materials: For 12 prostate patients, scanned beam carbon ion treatment plans were prepared using 2 lateral opposed beams and the raster scanning technique with different clinical target volume (CTV) to planning target volume (PTV) margins (2-10 mm). Internal target motion of 2-15 mm in anteroposterior (AP), superoinferior (SI), and left-to-right (LR) directions was simulated by displacing the CTV contours with respect to the computed tomography data. The plans were recalculated with and without target-based isocenter realignment and the CTV coverage was assessed. Results: For CTV shifts within the applied planning margin, the CI-98% is greater than 98.0%, both with and without isocenter realignment. Without realignment, because of the sharp lateral gradients, the CI-98% shows rapid fall as soon as the target shift exceeds the applied planning margin for all displacement directions. With isocenter realignment, the coverage improves notably for shifts in AP and SI directions and the CI-98% is restored to >95.0% for plans optimized with a 2-mm margin, >97% with a 3-mm margin, and >98% with larger margins. For large corrections, predominately in AP direction, cold spots in the CTV may occur. Their magnitude is dependent on the patients' individual anatomies. Conclusions: Within the physiological limits of internal prostate movement, target-based isocenter realignment results in improved CTV coverage for shifts in AP and SI directions exceeding the applied planning margin. Assuming optimal patient setup reproducibility (eg, immobilization, setup error correction, patient preparation protocols), hence negligible interfraction bone and soft-tissue variations, changes in traversed densities resulting from target-based realignment applied with a reduced planning margin do not induce significant dose deterioration in most of the cases.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

An empirical model of diagnostic x-ray attenuation under narrow-beam geometry

Purpose: The purpose of this study was to develop and validate a mathematical model to describe narrow-beam attenuation of kilovoltage x-ray beams for the intended applications of half-value layer (HVL) and quarter-value layer (QVL) estimations, patient organ shielding, and computer modeling. Methods: An empirical model, which uses the Lambert W function and represents a generalized Lambert-Beer law, was developed. To validate this model, transmission of diagnostic energy x-ray beams was measured over a wide range of attenuator thicknesses [0.49-33.03 mm Al on a computed tomography (CT) scanner, 0.09-1.93 mm Al on two mammography systems, and 0.1-0.45 mm Cu and 0.49-14.87 mm Al using general radiography]. Exposure measurements were acquired under narrow-beam geometry using standard methods, including the appropriate ionization chamber, for each radiographic system. Nonlinear regression was used to find the best-fit curve of the proposed Lambert W model to each measured transmission versus attenuator thickness data set. In addition to validating the Lambert W model, we also assessed the performance of two-point Lambert W interpolation compared to traditional methods for estimating the HVL and QVL [i.e., semilogarithmic (exponential) and linear interpolation]. Results: The Lambert W model was validated for modeling attenuation versus attenuator thickness with respect to the data collected in this study (R{sup 2} > 0.99). Furthermore, Lambert W interpolation was more accurate and less sensitive to the choice of interpolation points used to estimate the HVL and/or QVL than the traditional methods of semilogarithmic and linear interpolation. Conclusions: The proposed Lambert W model accurately describes attenuation of both monoenergetic radiation and (kilovoltage) polyenergetic beams (under narrow-beam geometry).

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗