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All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

SU-E-T-20: A Novel Hybrid CBCT, Bioluminescence and Fluorescence Tomography System for Preclinical Radiation Research

Purpose: A novel standalone bioluminescence and fluorescence tomography (BLT and FT) system equipped with high resolution CBCT has been built in our group. In this work, we present the system calibration method and validate our system in both phantom and in vivo environment. Methods: The CBCT is acquired by rotating the animal stage while keeping the x-ray source and detector panel static. The optical signal is reflected by the 3-mirror system to a multispectral filter set and then delivered to the CCD camera with f/1.4 lens mounted. Nine fibers passing through the stage and in contact with the mouse skin serve as the light sources for diffuse optical tomography (DOT) and FT. The anatomical information and optical properties acquired from the CBCT and DOT, respectively, are used as the priori information to improve the BLT/FT reconstruction accuracy. Flat field correction for the optical system was acquired at multiple wavelengths. A home-built phantom is used to register the optical and CBCT coordinates. An absolute calibration relating the CCD photon counts rate to the light fluence rate emitted at animal surface was developed to quantify the bioluminescence power or fluorophore concentration. Results: An optical inhomogeneous phantom with 2 light sources (3mm separation) imbedded is used to test the system. The optical signal is mapped onto the mesh generated from CBCT for optical reconstruction. Our preliminary results show that the center of mass can be reconstructed within 2.8mm accuracy. A live mouse with the light source imbedded is also used to validate our system. Liver or lung metastatic luminescence tumor model will be used for further testing. Conclusion: This hybrid system transforms preclinical research to a level that even sub-palpable volume of cells can be imaged rapidly and non-invasively, which largely extends the scope of radiobiological research. The research is supported by the NCI grant R01CA158100-01.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-AB-BRA-08: Results of a Multi-Institutional Study for the Evaluation of Deformable Image Registration Algorithms for Structure Delineation Via Computational Phantoms

Purpose: To investigate the accuracy of various algorithms for deformable image registration (DIR), to propagate regions of interest (ROIs) in computational phantoms based on patient images using different commercial systems. This work is part of an Italian multi-institutional study to test on common datasets the accuracy, reproducibility and safety of DIR applications in Adaptive Radiotherapy. Methods: Eleven institutions with three available commercial solutions provided data to assess the agreement of DIR-propagated ROIs with automatically drown ROIs considered as ground-truth for the comparison. The DIR algorithms were tested on real patient data from three different anatomical districts: head and neck, thorax and pelvis. For every dataset two specific Deformation Vector Fields (DVFs) provided by ImSimQA software were applied to the reference data set. Three different commercial software were used in this study: RayStation, Velocity and Mirada. The DIR-mapped ROIs were then compared with the reference ROIs using the Jaccard Conformity Index (JCI). Results: More than 600 DIR-mapped ROIs were analyzed. Putting together all JCI data of all institutions for the first DVF, the mean JCI was 0.87 ± 0.7 (1 SD) while for the second DVF JCI was 0.8 ± 0.13 (1 SD). Several considerations on different structures are available from collected data: the standard deviation among different institutions on specific structure raise as the larger is the applied DVF. The higher value is 10% for bladder. Conclusion: Although the complexity of deformation of human body is very difficult to model, this work illustrates some clinical scenarios with well-known DVFs provided by specific software. CI parameter gives the inter-user variability and may put in evidence the need of improving the working protocol in order to reduce the inter-institution JCI variability.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-218: Predicting Radiation-Induced Xerostomia by Dosimetrically Accounting for Daily Setup Uncertainty During Head and Neck IMRT

Purpose: To determine if the accumulated parotid dosimetry using planning CT to daily CBCT deformation and dose re-calculation can predict for radiation-induced xerostomia. Methods: To track and dosimetrically account for the effects of anatomical changes on the parotid glands, we propagated physicians’ contours from planning CT to daily CBCT using a deformable registration with iterative CBCT intensity correction. A surface mesh for each OAR was created with the deformation applied to the mesh to obtain the deformed parotid volumes. Daily dose was computed on the deformed CT and accumulated to the last fraction. For both the accumulated and the planned parotid dosimetry, we tested the prediction power of different dosimetric parameters including D90, D50, D10, mean, standard deviation, min/max dose to the combined parotids and patient age to severe xerostomia (NCI-CTCAE grade≥2 at 6 mo follow-up). We also tested the dosimetry to parotid sub-volumes. Three classification algorithms, random tree, support vector machine, and logistic regression were tested to predict severe xerostomia using a leave-one-out validation approach. Results: We tested our prediction model on 35 HN IMRT cases. Parameters from the accumulated dosimetry model demonstrated an 89% accuracy for predicting severe xerostomia. Compared to the planning dosimetry, the accumulated dose consistently demonstrated higher prediction power with all three classification algorithms, including 11%, 5% and 30% higher accuracy, sensitivity and specificity, respectively. Geometric division of the combined parotid glands into superior-inferior regions demonstrated ∼5% increased accuracy than the whole volume. The most influential ranked features include age, mean accumulated dose of the submandibular glands and the accumulated D90 of the superior parotid glands. Conclusion: We demonstrated that the accumulated parotid dosimetry using CT-CBCT registration and dose re-calculation more accurately predicts for severe xerostomia and that the superior portion of the parotid glands may be particularly important in predicting for severe xerostomia. This work was supported in part by NIH/NCI under grant R42CA137886 and in part by Toshiba big data research project funds.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2023

Impact of Anatomical Fractionation of Corn Stover on Hammer Mill Throughput and Energy Consumption

The goal of this Case Study was to quantify the impacts of variable moisture and ash on hammer mill throughput and energy consumption and on loss of very wet stover that causes failures in the first stage grinder and that are not able to be fed to conversion, as compared to a status quo Base Case system. Also considered was convertible carbohydrate content (minimum total carbohydrate specification), maximum ash content and the delivered feedstock cost impacts of not being able to feed stover that did not meet the total carbohydrate specification to the conversion reactor. Laboratory data on the impacts of moisture content and tissue fraction on throughput and energy consumption in a stage 2 hammer mill were received from FCIC Subtask 5.1: Preprocessing, Corn Stover Preprocessing (Neal Yancey and Sergio Hernandez, INL). Additional air classifier throughput, energy consumption and separation efficiency data were obtained from FCIC Subtask 5.1 (Neal Yancey, INL) for the new air classifier, which has three exit streams (lights, middle and heavies). These data were utilized to develop the necessary response surface equations to perform throughput analysis using discrete event simulation. Because the ash contents and particle sizes had not been analyzed in the laboratory at the time of the model runs, we assumed that the ash distributed proportionally with total mass into the lights and heavies in an air classifier having two exit streams (lights and heavies) and that the lights fraction from the air classifier was not removed.

ash content↗
DOE OSTI2014

Calculated and Measured Dose Distributions in an Anthropomorphic RANDO Phantom - Paper 105

Patient-specific quality assurance (QA) is a major component of the Intensity Modulated Radiation Therapy (IMRT) clinical process. The objective of this often time-intensive measurement process is to verify that the prescribed dose is accurately delivered to the target volume while sparing surrounding healthy tissue. The IMRT dose distributions can be measured using a wide variety of techniques and measurement devices including film (radiographic and radiochromic), ion chamber arrays, diode arrays, and Electronic Portal Imaging Devices (EPIDs). Of all the available modalities, film is one of the most versatile and most frequently utilized measurement systems. In rotation delivery techniques (such as volume modulated arc therapy and helical tomotherapy), composite dose distributions are obtained by irradiating a test phantom containing dosimeter(s). When film is utilized as the dosimeter, it can be placed in coronal, sagittal, or transverse planes inside the phantom. Because the film is irradiated using the rotational delivery sequence used to treat the patient, the dose given to specific anatomical structures (such as the parotids, spinal cord, bladder, rectum etc...) can be evaluated. Thomas et al (Med Phys 32: 3793-3800) recently reported the results of IMRT verifications for ten patients planned and treated with helical tomotherapy. This study reported that nearly 92% of the film pixels within the analyzed region of interest were within a gamma criterion of 2 mm and 2%. Like most tomotherapy users, Thomas et al used a test phantom made of homogeneous water equivalent material. Heterogeneous phantoms that simulate the different tissue densities in the human body do exist, but are infrequently used for patient-specific IMRT QA. The potential advantage of using heterogeneous phantoms is that the measured dose distributions will more adequately reflect the clinical dose distributions in the patients. The use of homogenous phantoms during IMRT quality assurance can potentially mask errors that arise from limitations in the treatment planning system's modeling of density corrections. The purpose of this study was to evaluate the dosimetric accuracy of a helical tomotherapy system using an anthropomorphic RANDO phantom (The Phantom Laboratory, Salem, NY) for patient-specific QA. The results of this study will allow a benchmark to be established for dosimetric accuracy in heterogeneous materials. Performing patient-specific QA is an integral part of the IMRT patient treatment process. Test phantoms are typically homogeneous, and do test the treatment planning systems ability to account for heterogeneity corrections. In this study, an anthropomorphic RANDO phantom was used to evaluate the doses calculated by a helical tomotherapy system. The dosimetric agreement between calculated and measured was worse than published results in homogenous phantoms, especially for target volumes located in the lung. Further investigation will be needed to determine if these errors are due to film response at heterogeneous tissue interfaces or from actual dose calculation errors. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

TU-C-BRE-07: Quantifying the Clinical Impact of VMAT Delivery Errors Relative to Prior Patients’ Plans and Adjusted for Anatomical Differences

Purpose: There is increased interest in the Radiation Oncology Physics community regarding sensitivity of pre-treatment IMRT/VMAT QA to delivery errors. Consequently, tools mapping pre-treatment QA to the patient DVH have been developed. However, the quantity of plan degradation that is acceptable remains uncertain. Using DVHs adapted from prior patients’ plans, we developed a technique to determine the magnitude of various delivery errors required to degrade a treatment plan to outside the clinically accepted range. Methods: DVHs for relevant organs at risk were adapted from a population of prior patients’ plans using a machine learning algorithm to establish the clinically acceptable DVH range specific to the patient’s anatomy. We applied this technique to six low-risk prostate cancer patients treated with single-arc VMAT and compared error-induced DVH changes to the adapted DVHs to determine the magnitude of error required to push the plan outside of the acceptable range. The procedure follows: (1) Errors (systematic ' random shift of MLCs, gantry-MLC desynchronization, dose rate fluctuations, etc.) were simulated and degraded DVHs calculated using the Varian Eclipse TPS. (2) Adapted DVHs and acceptable ranges for DVHs were established. (3) Relevant dosimetric indices and corresponding acceptable ranges were calculated from the DVHs. Key indices included NTCP (Lyman-Kutcher-Burman Model) and QUANTEC’s dose-volume Objectives: s of V75Gy≤0.15 for the rectum and V75Gy≤0.25 for the bladder. Results: Degradations to the clinical plan became “unacceptable” for 19±29mm and 1.9±2.0mm systematic outward shifts of a single leaf and leaf bank, respectively. All other simulated errors fell within the acceptable range. Conclusion: Utilizing machine learning and prior patients’ plans one can predict a clinically acceptable range of DVH degradation for a specific patient. Comparing error-induced DVH degradations to this range, it is shown that single-arc VMAT plans for low-risk prostate are relatively insensitive to many potential delivery errors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Endoluminal ultrasound applicators for MR-guided thermal ablation of pancreatic tumors: Preliminary design and evaluation in a porcine pancreas model

Purpose: Endoluminal ultrasound may serve as a minimally invasive option for delivering thermal ablation to pancreatic tumors adjacent to the stomach or duodenum. The objective of this study was to explore the basic feasibility of this treatment strategy through the design, characterization, and evaluation of proof-of-concept endoluminal ultrasound applicators capable of placement in the gastrointestinal (GI) lumen for volumetric pancreas ablation under MR guidance. Methods: Two variants of the endoluminal applicator, each containing a distinct array of two independently powered transducers (10 × 10 mm 3.2 MHz planar; or 8 × 10 × 20 mm radius of curvature 3.3 MHz curvilinear geometries) at the distal end of a meter long flexible catheter assembly, were designed and fabricated. Transducers and circulatory water flow for acoustic coupling and luminal cooling were contained by a low-profile polyester balloon covering the transducer assembly fixture. Each applicator incorporated miniature spiral MR coils and mechanical features (guiding tips and hinges) to facilitate tracking and insertion through the GI tract under MRI guidance. Acoustic characterization of each device was performed using radiation force balance and hydrophone measurements. Device delivery into the upper GI tract, adjacent to the pancreas, and heating characteristics for treatment of pancreatic tissue were evaluated in MR-guided ex vivo and in vivo porcine experiments. MR guidance was utilized for anatomical target identification, tracking/positioning of the applicator, and MR temperature imaging (MRTI) for PRF-based multislice thermometry, implemented in the real-time RTHawk software environment. Results: Force balance and hydrophone measurements indicated efficiencies of 48.8% and 47.8% and −3 dB intensity beam-widths of 3.2 and 1.2 mm for the planar and curvilinear transducers, respectively. Ex vivo studies on whole-porcine carcasses revealed capabilities of producing ablative temperature rise (ΔT > 15 °C) contours in pancreatic tissue 4–40 mm long and 4–28 mm wide for the planar transducer applicator (1–13 min sonication duration, ∼4 W/cm{sup 2} applied acoustic intensity). Curvilinear transducers produced more selective heating, with a narrower ΔT > 15 °C contour length and width of up to 1–24 mm and 2–7 mm, respectively (1–7 min sonication duration, ∼4 W/cm{sup 2} applied acoustic intensity). Active tracking of the miniature spiral coils was achieved using a Hadamard encoding tracking sequence, enabling real-time determination of each coil’s coordinates and automated prescription of imaging planes for thermometry. In vivo MRTI-guided heating trials in three pigs demonstrated capability of ∼20 °C temperature elevation in pancreatic tissue at 2 cm depths from the applicator, with 5–7 W/cm{sup 2} applied intensity and 6–16 min sonication duration. Dimensions of thermal lesions in the pancreas ranged from 12 to 28 mm, 3 to 10 mm, and 5 to 10 mm in length, width, and depth, respectively, as verified through histological analysis of tissue sections. Multiple-baseline reconstruction and respiratory-gated acquisition were demonstrated to be effective strategies in suppressing motion artifacts for clear evolution of temperature profiles during MRTI in the in vivo studies. Conclusions: This study demonstrates the technical feasibility of generating volumetric ablation in pancreatic tissue using endoluminal ultrasound applicators positioned in the stomach lumen. MR guidance facilitates target identification, device tracking/positioning, and treatment monitoring through real-time multislice PRF-based thermometry.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-EF-BRA-03: Catheter- Free Ablation with External Photon Radiation: Treatment Planning, Delivery Considerations, and Correlation of Effects with Delivered Dose

Purpose: To plan, target, and calculate delivered dose in atrioventricular node (AVN) ablation with volume-modulated arc therapy (VMAT) in an intact porcine model. Methods: Seven pigs underwent AVN irradiation, with prescription doses ranging between 25 and 55Gy in a single fraction. Cardiac CT scans were acquired at expiration. Two physicians contoured AVN targets on 10 phases, providing estimates of target motion and inter-physician variability. Treatment planning was conducted on a static phase-averaged CT. The volume designated to receive prescription dose covered the full extent of AVN cardiac motion, expanded by 4mm for setup uncertainty. Optimization limited doses to risk structures according to single-fraction tumor treatment protocols. Orthogonal kV images were used to align bony anatomy at time of treatment. Localization was further refined with respiratory-gated cone-beam CT, and range of cardiac motion was verified under fluoroscopy. Beam delivery was respiratory-gated for expiration with a mean efficiency of 60%. Deformable registration of the 10 cardiac CT phases was used to calculate actual delivered dose for comparison to electro-anatomical and visually evident lesions. Results: The mean [minimum,maximum] amplitude of AVN cardiac motion was LR 2.9 [1.7,3.9]mm, AP 6.6 [4.4,10.4]mm, and SI 5.6 [2.0,9.9]mm. Incorporating cardiac motion into the dose calculation showed the volume receiving full dose was 40–80% of the volume indicated on the static planning image, although the contoured AVN target received full dose in all animals. Initial results suggest the dimensions of the electro-anatomical lesion are correlated with the 40Gy isodose volume. Conclusion: Image-guidance techniques allow for accurate and precise delivery of VMAT for catheter-free arrhythmia ablation. An arsenal of advanced radiation planning, dose optimization, and image-guided delivery techniques was employed to assess and mitigate effects of cardiac and respiratory motion. Feasibility of delivery to the pulmonary veins and left ventricular myocardium will be investigated in future studies. D. Packer Disclosures: Abiomed, Biosense Webster, Inc., Boston Scientific Corp., CardioFocus, Inc., Johnson and Johnson, Excerpta Medica, Ortho-McNeil-Jannsen, Sanofi Aventis, CardioInsight Technologies, InfoBionic, SIEMENS, Medtronic, Inc., CardioDx, Inc., CardioInsight Technologies, FoxP2 Medica, Mediasphere Medical, Wiley-Blackwell, St. Jude Medical, Endosense, Thermedical, EP Advocate LLC, Hansen Medical, American Heart Association, EpiEP, NIH.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2003

Introduction to Radiation Issues for International Space Station Extravehicular Activities

The International Space Station (ISS) provides significant challenges for radiation protection of the crew due to a combination of circumstances including: the extended duration of missions for many crewmembers, the exceptionally dynamic nature of the radiation environment in ISS orbit, and the necessity for numerous planned extravehicular activities (EVA) for station construction and maintenance. Radiation protection requires accurate radiation dose measurements and precise risk modeling of the transmission of high fluxes of energetic electrons and protons through the relatively thin shielding provided by the space suits worn during EVA. Experiments and analyses have been performed due to the necessity to assure complete radiation safety for the EVA crew and thereby ensure mission success. The detailed characterization described of the material and topological properties of the ISS space suits can be used as a basis for design of space suits used in future exploration missions. In radiation protection practices, risk from exposure to ionizing radiation is determined analytically by the level of exposure, the detrimental quality of the radiation field, the inherent radiosensitivity of the tissues or organs irradiated, and the age and gender of the person at the time of exposure. During low Earth orbit (LEO) EVA, the relatively high fluxes of low-energy electrons and protons lead to large variations in exposure of the skin, lens of the eye, and tissues in other shallow anatomical locations. The technical papers in this publication describe a number of ground-based experiments that precisely measure the thickness of the NASA extravehicular mobility unit (EMU) and Russian Zvezda Orlan-M suits using medical computerized tomography (CT) X-ray analysis, and particle accelerator experiments that measure the minimum kinetic energy required by electrons and photons to penetrate major components of the suits. These studies provide information necessary for improving the understanding of the current ISS space suits and provide insights into improved approaches for the design of future suits. This chapter begins with a summary of the dynamic ionizing radiation environment in LEO space and introduces the concepts and quantities used to quantify exposure to space radiation in LEO. The space suits used for EVA and the experimental partial human phantom are described. Subsequent chapters report results from measured charged particle fields before and after incident protons and secondary particles are transported through the space suits and into organs and tissues.

Shavers, M. R.↗
DOE OSTI2020

The skin microbiome of elasmobranchs follows phylosymbiosis, but in teleost fishes, the microbiomes converge

Background: The vertebrate clade diverged into Chondrichthyes (sharks, rays, and chimeras) and Osteichthyes fishes (bony fishes) approximately 420 mya, with each group accumulating vast anatomical and physiological differences, including skin properties. The skin of Chondrichthyes fishes is covered in dermal denticles, whereas Osteichthyes fishes are covered in scales and are mucous rich. The divergence time among these two fish groups is hypothesized to result in predictable variation among symbionts. Here, using shotgun metagenomics, we test if patterns of diversity in the skin surface microbiome across the two fish clades match predictions made by phylosymbiosis theory. In this work, we hypothesize (1) the skin microbiome will be host and clade-specific, (2) evolutionary difference in elasmobranch and teleost will correspond with a concomitant increase in host-microbiome dissimilarity, and (3) the skin structure of the two groups will affect the taxonomic and functional composition of the microbiomes. Results: We show that the taxonomic and functional composition of the microbiomes is host-specific. Teleost fish had lower average microbiome within clade similarity compared to among clade comparison, but their composition is not different among clade in a null based model. Elasmobranch’s average similarity within clade was not different than across clade and not different in a null based model of comparison. In the comparison of host distance with microbiome distance, we found that the taxonomic composition of the microbiome was related to host distance for the elasmobranchs, but not the teleost fishes. In comparison, the gene function composition was not related to the host-organism distance for elasmobranchs but was negatively correlated with host distance for teleost fishes. Conclusion: Our results show the patterns of phylosymbiosis are not consistent across both fish clades, with the elasmobranchs showing phylosymbiosis, while the teleost fish are not. The discrepancy may be linked to alternative processes underpinning microbiome assemblage, including possible historical host-microbiome evolution of the elasmobranchs and convergent evolution in the teleost which filter specific microbial groups. Our comparison of the microbiomes among fishes represents an investigation into the microbial relationships of the oldest divergence of extant vertebrate hosts and reveals that microbial relationships are not consistent across evolutionary timescales.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2014

SU-E-J-113: The Influence of Optimizing Pediatric CT Simulator Protocols On the Treatment Dose Calculation in Radiotherapy

Purpose: To investigate the possibility of applying optimized scanning protocols for pediatric CT simulation by quantifying the dosimetric inaccuracy introduced by using a fixed HU to density conversion. Methods: The images of a CIRS electron density reference phantom (Model 062) were acquired by a Siemens CT simulator (Sensation Open) using the following settings of tube voltage and beam current: 120 kV/190mA (the reference protocol used to calibrate CT for our treatment planning system (TPS)); Fixed 190mA combined with all available kV: 80, 100, and 140; fixed 120 kV and various current from 37 to 444 mA (scanner extremes) with interval of 30 mA. To avoid the HU uncertainty of point sampling in the various inserts of known electron densities, the mean CT numbers of the central cylindrical volume were calculated using DICOMan software. The doses per 100 MU to the reference point (SAD=100cm, Depth=10cm, Field=10X10cm, 6MV photon beam) in a virtual cubic phantom (30X30X30cm) were calculated using Eclipse TPS (calculation model: AcurosXB-11031) by assigning the CT numbers to HU of typical materials acquired by various protocols. Results: For the inserts of densities less than muscle, CT number fluctuations of all protocols were within the tolerance of 10 HU as accepted by AAPM-TG66. For more condensed materials, fixed kV yielded stable HU with any mA combination where largest disparities were found in 1750mg/cc insert: HU{sub reference}=1801(106.6cGy), HU{sub minimum}=1799 (106.6cGy, error{sub dose}=0.00%), HU{sub maximum}=1815 (106.8cGy, error{sub dose}=0.19%). Yet greater disagreements were observed with increasing density when kV was modified: HU{sub minimum}=1646 (104.5cGy, error{sub dose}=- 1.97%), HU{sub maximum}=2487 (116.4cGy, error{sub dose}=9.19%) in 1750mg/cc insert. Conclusion: Without affecting treatment dose calculation, personalized mA optimization of CT simulator can be conducted by fixing kV for a better cost-effectiveness of imaging dose and quality especially for children. Unless recalibrated, kV should be constant for all anatomical sites if diagnostic CT scanner is used as a simulator. This work was partially supported by Capital Medical Development Scientific Research Fund of China.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection

Purpose: We previously developed a multigene expression model of tumor radiation sensitivity index (RSI) with clinical validation in multiple independent cohorts (breast, rectal, esophageal, and head and neck patients). The purpose of this study was to assess differences between RSI scores in primary colon cancer and metastases. Methods and Materials: Patients were identified from our institutional review board–approved prospective observational protocol. A total of 704 metastatic and 1362 primary lesions were obtained from a de-identified metadata pool. RSI was calculated using the previously published rank-based algorithm. An independent cohort of 29 lung or liver colon metastases treated with 60 Gy in 5 fractions stereotactic body radiation therapy (SBRT) was used for validation. Results: The most common sites of metastases included liver (n=374; 53%), lung (n=116; 17%), and lymph nodes (n=40; 6%). Sixty percent of metastatic tumors, compared with 54% of primaries, were in the RSI radiation-resistant peak, suggesting metastatic tumors may be slightly more radiation resistant than primaries (P=.01). In contrast, when we analyzed metastases based on anatomical site, we uncovered large differences in RSI. The median RSIs for metastases in descending order of radiation resistance were ovary (0.48), abdomen (0.47), liver (0.43), brain (0.42), lung (0.32), and lymph nodes (0.31) (P<.0001). These findings were confirmed when the analysis was restricted to lesions from the same patient (n=139). In our independent cohort of treated lung and liver metastases, lung metastases had an improved local control rate compared to that in patients with liver metastases (2-year local control rate of 100% vs 73.0%, respectively; P=.026). Conclusions: Assessment of radiation sensitivity between primary and metastatic tissues of colon cancer histology revealed significant differences based on anatomical location of metastases. These initial results warrant validation in a larger clinical cohort.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Simultaneous 3D–2D image registration and C-arm calibration: Application to endovascular image-guided interventions

Purpose: Three-dimensional to two-dimensional (3D–2D) image registration is a key to fusion and simultaneous visualization of valuable information contained in 3D pre-interventional and 2D intra-interventional images with the final goal of image guidance of a procedure. In this paper, the authors focus on 3D–2D image registration within the context of intracranial endovascular image-guided interventions (EIGIs), where the 3D and 2D images are generally acquired with the same C-arm system. The accuracy and robustness of any 3D–2D registration method, to be used in a clinical setting, is influenced by (1) the method itself, (2) uncertainty of initial pose of the 3D image from which registration starts, (3) uncertainty of C-arm’s geometry and pose, and (4) the number of 2D intra-interventional images used for registration, which is generally one and at most two. The study of these influences requires rigorous and objective validation of any 3D–2D registration method against a highly accurate reference or “gold standard” registration, performed on clinical image datasets acquired in the context of the intervention. Methods: The registration process is split into two sequential, i.e., initial and final, registration stages. The initial stage is either machine-based or template matching. The latter aims to reduce possibly large in-plane translation errors by matching a projection of the 3D vessel model and 2D image. In the final registration stage, four state-of-the-art intrinsic image-based 3D–2D registration methods, which involve simultaneous refinement of rigid-body and C-arm parameters, are evaluated. For objective validation, the authors acquired an image database of 15 patients undergoing cerebral EIGI, for which accurate gold standard registrations were established by fiducial marker coregistration. Results: Based on target registration error, the obtained success rates of 3D to a single 2D image registration after initial machine-based and template matching and final registration involving C-arm calibration were 36%, 73%, and 93%, respectively, while registration accuracy of 0.59 mm was the best after final registration. By compensating in-plane translation errors by initial template matching, the success rates achieved after the final stage improved consistently for all methods, especially if C-arm calibration was performed simultaneously with the 3D–2D image registration. Conclusions: Because the tested methods perform simultaneous C-arm calibration and 3D–2D registration based solely on anatomical information, they have a high potential for automation and thus for an immediate integration into current interventional workflow. One of the authors’ main contributions is also comprehensive and representative validation performed under realistic conditions as encountered during cerebral EIGI.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Anatomical pulmonary magnetic resonance imaging segmentation for regional structure-function measurements of asthma

Purpose: Pulmonary magnetic-resonance-imaging (MRI) and x-ray computed-tomography have provided strong evidence of spatially and temporally persistent lung structure-function abnormalities in asthmatics. This has generated a shift in their understanding of lung disease and supports the use of imaging biomarkers as intermediate endpoints of asthma severity and control. In particular, pulmonary {sup 1}H MRI can be used to provide quantitative lung structure-function measurements longitudinally and in response to treatment. However, to translate such biomarkers of asthma, robust methods are required to segment the lung from pulmonary {sup 1}H MRI. Therefore, their objective was to develop a pulmonary {sup 1}H MRI segmentation algorithm to provide regional measurements with the precision and speed required to support clinical studies. Methods: The authors developed a method to segment the left and right lung from {sup 1}H MRI acquired in 20 asthmatics including five well-controlled and 15 severe poorly controlled participants who provided written informed consent to a study protocol approved by Health Canada. Same-day spirometry and plethysmography measurements of lung function and volume were acquired as well as {sup 1}H MRI using a whole-body radiofrequency coil and fast spoiled gradient-recalled echo sequence at a fixed lung volume (functional residual capacity + 1 l). We incorporated the left-to-right lung volume proportion prior based on the Potts model and derived a volume-proportion preserved Potts model, which was approximated through convex relaxation and further represented by a dual volume-proportion preserved max-flow model. The max-flow model led to a linear problem with convex and linear equality constraints that implicitly encoded the proportion prior. To implement the algorithm, {sup 1}H MRI was resampled into ∼3 × 3 × 3 mm{sup 3} isotropic voxel space. Two observers placed seeds on each lung and on the background of 20 pulmonary {sup 1}H MR images in a randomized dataset, on five occasions, five consecutive days in a row. Segmentation accuracy was evaluated using the Dice-similarity-coefficient (DSC) of the segmented thoracic cavity with comparison to five-rounds of manual segmentation by an expert observer. The authors also evaluated the root-mean-squared-error (RMSE) of the Euclidean distance between lung surfaces, the absolute, and percent volume error. Reproducibility was measured using the coefficient of variation (CoV) and intraclass correlation coefficient (ICC) for two observers who repeated segmentation measurements five-times. Results: For five well-controlled asthmatics, forced expiratory volume in 1 s (FEV{sub 1})/forced vital capacity (FVC) was 83% ± 7% and FEV{sub 1} was 86 ± 9%{sub pred}. For 15 severe, poorly controlled asthmatics, FEV{sub 1}/FV C = 66% ± 17% and FEV{sub 1} = 72 ± 27%{sub pred}. The DSC for algorithm and manual segmentation was 91% ± 3%, 92% ± 2% and 91% ± 2% for the left, right, and whole lung, respectively. RMSE was 4.0 ± 1.0 mm for each of the left, right, and whole lung. The absolute (percent) volume errors were 0.1 l (∼6%) for each of right and left lung and ∼0.2 l (∼6%) for whole lung. Intra- and inter-CoV (ICC) were <0.5% (>0.91%) for DSC and <4.5% (>0.93%) for RMSE. While segmentation required 10 s including ∼6 s for user interaction, the smallest detectable difference was 0.24 l for algorithm measurements which was similar to manual measurements. Conclusions: This lung segmentation approach provided the necessary and sufficient precision and accuracy required for research and clinical studies.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Evaluating the Impact of a Canadian National Anatomy and Radiology Contouring Boot Camp for Radiation Oncology Residents

Background: Radiation therapy treatment planning has advanced over the past 2 decades, with increased emphasis on 3-dimensional imaging for target and organ-at-risk (OAR) delineation. Recent studies suggest a need for improved resident instruction in this area. We developed and evaluated an intensive national educational course (“boot camp”) designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary (MDT) approach. Methods: The anatomy and radiology contouring (ARC) boot camp was modeled after prior single-institution pilot studies and a needs-assessment survey. The boot camp incorporated joint lectures from radiation oncologists, anatomists, radiologists, and surgeons, with hands-on contouring instruction and small group interactive seminars using cadaveric prosections and correlative axial radiographs. Outcomes were evaluated using pretesting and posttesting, including anatomy/radiology multiple-choice questions (MCQ), timed contouring sessions (evaluated relative to a gold standard using Dice similarity metrics), and qualitative questions on satisfaction and perceived effectiveness. Analyses of pretest versus posttest scores were performed using nonparametric paired testing. Results: Twenty-nine radiation oncology residents from 10 Canadian universities participated. As part of their current training, 29%, 75%, and 21% receive anatomy, radiology, and contouring instruction, respectively. On posttest scores, the MCQ knowledge scores improved significantly (pretest mean 60% vs posttest mean 80%, P<.001). Across all contoured structures, there was a 0.20 median improvement in students' average Dice score (P<.001). For individual structures, significant Dice improvements occurred in 10 structures. Residents self-reported an improved ability to contour OARs and interpret radiographs in all anatomic sites, 92% of students found the MDT format effective for their learning, and 93% found the boot camp more effective than educational sessions at their own institutions. All of the residents (100%) would recommend this course to others. Conclusions: The ARC boot camp is an effective intervention for improving radiation oncology residents' knowledge and understanding of anatomy and radiology in addition to enhancing their confidence and accuracy in contouring.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-E-I-39: Combining Conventional Tomographic Imaging Strategy and Interior Tomography for Low Dose Dual-Energy CT (DECT)

Purpose: Dual-energy CT (DECT) affords quantitative information of tissue density and provides a new dimension for disease diagnosis and treatment planning. The technique, however, increases the imaging dose because of the doubled scans, and thus hinders its widespread clinical applications. The purpose of this work is to develop a novel hybrid DECT image acquisition and reconstruction strategy, in which one of the energies is dealt by interior tomography while the other one is obtained using conventional tomography approach. Methods: In the proposed hybrid imaging strategy, the projection data of one of the energies (e.g., high-energy) were acquired and processed in an interior scanning model, whereas the other energy in the conventional tomographic approach. It known that, if the ROI is piecewise constant or polynomial, the interior ROI can be reconstructed with TV or HOT minimization. Here we extend the TV based interior reconstruction method into dual-energy situation. The ROI images so obtained were overlaid in the context of conventional CT of the companion energy. A material based composition in ROI was used in the proposed reconstruction framework. Results: In the simulation experiment with a diagnostic DECT geometry and energies, we were able to derive the densities of soft-tissues and bones in the ROI with high fidelity. In the experimental CBCT study, both kV and MV data were collected using the on-board kV and MV imaging system. The MV data were truncated only across the ROI. Using the interior tomography reconstruction above, we were able to obtain the ROI images as that obtained using un-truncated MV data with known tissue densities. Conclusion: The proposed DECT imaging strategy provides an effective way to extract tissue density information in the ROI and in the context of anatomical images of CT imaging, with much reduced imaging dose.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2005

Diagnostic instrumentation aboard ISS: just-in-time training for non-physician crewmembers

INTRODUCTION: The performance of complex tasks on the International Space Station (ISS) requires significant preflight crew training commitments and frequent skill and knowledge refreshment. This report documents a recently developed "just-in-time" training methodology, which integrates preflight hardware familiarization and procedure training with an on-orbit CD-ROM-based skill enhancement. This "just-in-time" concept was used to support real-time remote expert guidance to complete ultrasound examinations using the ISS Human Research Facility (HRF). METHODS: An American and Russian ISS crewmember received 2 h of "hands on" ultrasound training 8 mo prior to the on-orbit ultrasound exam. A CD-ROM-based Onboard Proficiency Enhancement (OPE) interactive multimedia program consisting of memory enhancing tutorials, and skill testing exercises, was completed by the crewmember 6 d prior to the on-orbit ultrasound exam. The crewmember was then remotely guided through a thoracic, vascular, and echocardiographic examination by ultrasound imaging experts. RESULTS: Results of the CD-ROM-based OPE session were used to modify the instructions during a complete 35-min real-time thoracic, cardiac, and carotid/jugular ultrasound study. Following commands from the ground-based expert, the crewmember acquired all target views and images without difficulty. The anatomical content and fidelity of ultrasound video were adequate for clinical decision making. CONCLUSIONS: Complex ultrasound experiments with expert guidance were performed with high accuracy following limited preflight training and multimedia based in-flight review, despite a 2-s communication latency. In-flight application of multimedia proficiency enhancement software, coupled with real-time remote expert guidance, facilitates the successful performance of ultrasound examinations on orbit and may have additional terrestrial and space applications.

Inservice Training/methods↗
NASA NTRS1999

Electroencephalographic imaging of higher brain function

High temporal resolution is necessary to resolve the rapidly changing patterns of brain activity that underlie mental function. Electroencephalography (EEG) provides temporal resolution in the millisecond range. However, traditional EEG technology and practice provide insufficient spatial detail to identify relationships between brain electrical events and structures and functions visualized by magnetic resonance imaging or positron emission tomography. Recent advances help to overcome this problem by recording EEGs from more electrodes, by registering EEG data with anatomical images, and by correcting the distortion caused by volume conduction of EEG signals through the skull and scalp. In addition, statistical measurements of sub-second interdependences between EEG time-series recorded from different locations can help to generate hypotheses about the instantaneous functional networks that form between different cortical regions during perception, thought and action. Example applications are presented from studies of language, attention and working memory. Along with its unique ability to monitor brain function as people perform everyday activities in the real world, these advances make modern EEG an invaluable complement to other functional neuroimaging modalities.

Non-NASA Center↗