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At least 415 records · Page 23

A Modern Load Relief Guidance Scheme for Space Launch Vehicles

Launch vehicle load relief algorithms are concerned with realizing a reduction of transient bending moments near maximum dynamic pressure. Traditional approaches to load relief typically use inner-loop acceleration feedback to reduce the wind-induced angle of attack. When implemented in the inner loop, load relief bandwidth is necessarily limited by the achievable stability margins, and when acceleration feedback is employed, by the uncertainty associated with structural modes that couple with the body-mounted accelerometer. The structure of inner loop load relief increases the dimensionality of the flight control gain and filter optimization problem. Most importantly, classical load relief laws do not take advantage of high-rate and high-accuracy GPS-aided inertial velocity data that is readily available from modern strap down IMUs. In this paper, a novel load relief guidance scheme is described that uses direct angle-of-attack feedback in a clever mechanization. The steering commands are determined by examining the wind-perturbed dynamics of a launch vehicle with respect to a gravity turn ascent trajectory. An angle of attack estimate is derived from GPS-aided inertial data and pre-launch range wind measurements, and it is shown that a reduction worst-case rigid-body loads can be realized without requiring air data. The algorithm also includes a high-rate navigation data preprocessing scheme that operates directly on the IMU delta-theta and delta-velocity measurements in order to produce a filtered acceleration estimate at the vehicle center of mass. The outer-loop guidance scheme simplifies the design process for the classical inner-loop autopilot. Algorithm performance is demonstrated using Monte Carlo analysis of a representative liquid booster in a production high fidelity launch vehicle simulation.

NESC↗

Guidance, Navigation, and Control for Laser-Based Non-Cooperative Target Detumbling

Orbital debris is a well known and growing problem presenting risks to the future of spaceflight. Many pieces of debris are defunct satellites or rocket upper stages. These large objects could generate an exponentially growing cloud of debris should they be involved in a collision, i.e., Kessler Syndrome. Future orbital debris remediation efforts often propose perturbing the orbit of these large targets to mitigate risk. These plans often involve non-cooperative rendezvous. In the absence of active control, the targets are expected to be tumbling which makes rendezvous a dangerous prospect. In this work we describe a guidance, navigation, and control system for a contactless non-cooperative target detumbling methodology which will significantly increase the safety of non-cooperative rendezvous. An onboard laser generates thrust on the target by ablating its surface material. This thrust is used to control target attitude. Our guidance, navigation, and control system is able to estimate relative pose, target the laser, and maintain formation flight during the detumbling process. The system is validated with Monte Carlo simulation in a variety of scenarios.

Guidance↗

The Problem of Package Guidance with Incomplete Information for a Linear Control System with a Delay

The control-package method is applied to solve the problem of constructing guaranteed positional guidance for a linear control dynamical system with a delay under incomplete information about the initial state. The problem is solved for the case when the initial state is contained in a compact functional set. A solvability criterion and a method for the construction of a guidance program package are proposed. The proposed procedure is applied to a particular linear control system of delayed differential equations.

97 MATHEMATICS AND COMPUTING↗

Guidelines in review: Comparison of ESC and AHA guidance for the diagnosis and management of infective endocarditis in adults

Over recent years, new evidence has led a rethinking of the available guidance on the diagnosis and management of infective endocarditis (IE). This review compares the most recently available guidance provided by the American Heart Association (AHA) IE Writing Committee, and the Task Force for the management of IE of the European Society of Cardiology (ESC). This represents the sixth of a new series of comparative guidelines review published in the Journal.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Correlation between ECM guidance and actin polymerization on osteogenic differentiation of human adipose-derived stem cells

The correlation between extracellular matrix (ECM) components, cell shape, and stem cell guidance can shed light in understanding and mimicking the functionality of stem cell niches for various applications. This interplay on osteogenic guidance of human adipose-derived stem cells (hASCs) was focus of this study. Proliferation and osteogenic markers like alkaline phosphatase activity and calcium mineralization were slightly increased by the ECM components laminin (LA), collagen I (COL), and fibronectin (FIB); with control medium no differentiation occurred. ECM guided differentiation was rather dependent on osterix than on Runx2 pathway. FIB significantly enhanced cell elongation even in presence of actin polymerization blockers cytochalasin D (CytoD) and ROCK inhibitor Y-27632, which generally caused more rounded cells. Except for the COL surface, both inhibitors increased the extent of osterix, while the Runx2 pathway was more sensitive to the culture condition. Both inhibitors did not affect hASC proliferation. CytoD enabled osteogenic differentiation independently from the ECM, while it was rather blocked via Y-27632 treatment; on FIB the general highest extent of differentiation occurred. Taken together, the ECM effect on hASCs occurs indirectly and selectively via a dominant role of FIB: it sustains osteogenic differentiation in case of a tension-dependent control of actin polymerization. - Highlights: • Interplay of ECM and cell shape guides osteogenic differentiation of hASCs. • ECM components only present a promotive but not stimulative effect. • No direct correlation between ECM-enhanced cell elongation and differentiation. • Suppression of differentiation depends on a specific actin polymerization blocking. • Fibronectin sustains cell elongation and differentiation in case of blocking actin.

60 APPLIED LIFE SCIENCES↗

NELL2-Robo3 complex structure reveals mechanisms of receptor activation for axon guidance

Axon pathfinding is critical for nervous system development, and it is orchestrated by molecular cues that activate receptors on the axonal growth cone. Robo family receptors bind Slit guidance cues to mediate axon repulsion. In mammals, the divergent family member Robo3 does not bind Slits, but instead signals axon repulsion from its own ligand, NELL2. Conversely, canonical Robos do not mediate NELL2 signaling. Here, we present the structures of NELL-Robo3 complexes, identifying a mode of ligand engagement for Robos that is orthogonal to Slit binding. We elucidate the structural basis for differential binding between NELL and Robo family members and show that NELL2 repulsive activity is a function of its Robo3 affinity and is enhanced by ligand trimerization. Our results reveal a mechanism of oligomerization-induced Robo activation for axon guidance and shed light on Robo family member ligand binding specificity, conformational variability, divergent modes of signaling, and evolution.

59 BASIC BIOLOGICAL SCIENCES↗

Low dose tomographic fluoroscopy: 4D intervention guidance with running prior

Purpose: Today's standard imaging technique in interventional radiology is the single- or biplane x-ray fluoroscopy which delivers 2D projection images as a function of time (2D+T). This state-of-the-art technology, however, suffers from its projective nature and is limited by the superposition of the patient's anatomy. Temporally resolved tomographic volumes (3D+T) would significantly improve the visualization of complex structures. A continuous tomographic data acquisition, if carried out with today's technology, would yield an excessive patient dose. Recently the authors proposed a method that enables tomographic fluoroscopy at the same dose level as projective fluoroscopy which means that if scanning time of an intervention guided by projective fluoroscopy is the same as that of an intervention guided by tomographic fluoroscopy, almost the same dose is administered to the patient. The purpose of this work is to extend authors' previous work and allow for patient motion during the intervention.Methods: The authors propose the running prior technique for adaptation of a prior image. This adaptation is realized by a combination of registration and projection replacement. In a first step the prior is deformed to the current position via affine and deformable registration. Then the information from outdated projections is replaced by newly acquired projections using forward and backprojection steps. The thus adapted volume is the running prior. The proposed method is validated by simulated as well as measured data. To investigate motion during intervention a moving head phantom was simulated. Real in vivo data of a pig are acquired by a prototype CT system consisting of a flat detector and a continuously rotating clinical gantry.Results: With the running prior technique it is possible to correct for motion without additional dose. For an application in intervention guidance both steps of the running prior technique, registration and replacement, are necessary. Reconstructed volumes based on the running prior show high image quality without introducing new artifacts and the interventional materials are displayed at the correct position.Conclusions: The running prior improves the robustness of low dose 3D+T intervention guidance toward intended or unintended patient motion.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-D-BRF-07: Ultrasound and Fluoroscopy Based Intraoperative Image-Guidance System for Dynamic Dosimetry in Prostate Brachytherapy

Purpose: Prostate brachytherapy is a common treatment method for low-risk prostate cancer patients. Intraoperative treatment planning is known to improve the treatment procedure and the outcome. The current limitation of intraoperative treatment planning is the inability to localize the seeds in relation to the prostate. We developed an image-guidance system to fulfill this need to achieve intraoperative dynamic dosimetry in prostate brachytherapy. Methods: Our system is based on standard imaging equipments available in the operating room, including the transrectal ultrasound (TRUS) and the mobile C-arm. A simple fiducial is added to compute the C-arm pose. Three fluoroscopic images and an ultrasound volume of the seeds and the prostate are acquired and processed by four image processing algorithms: seed segmentation, fiducial detection with pose estimation, seed reconstruction, and seeds-to-TRUS registration. The updated seed positions allow the physician to assess the quality of implantation and dynamically adjust the treatment plan during the course of surgery to achieve improved exit dosimetry. Results: The system was tested on 10 phantoms and 37 patients. Seed segmentation resulted in a 1% false negative and 2% false positive rates. Fiducial detection with pose estimation resulted in a detection rate of 98%. Seed reconstruction had a mean reconstruction error of 0.4 mm. Seeds-to-TRUS registration had a mean registration error of 1.3 mm. The total processing time from image acquisition to registration was approximately 1 minute. Conclusion: We present an image-guidance system for intraoperative dynamic dosimetry in prostate brachytherapy. Using standard imaging equipments and a simple fiducial, our system can be easily adopted in any clinics. Robust image processing algorithms enable accurate and fast computation of the delivered dose. Especially, the system enables detection of possible hot/cold spots during the surgery, allowing the physician to address these in the operating room rather than requiring additional therapy afterwards. This research was supported in part by the National Institutes of Health/National Cancer Institute (NIH/NCI) under grant 2R44CA099374 and grant 1R01CA151395, and in part by the Department of Defense (DoD) under grant W81XWH-05-1-0407.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

MO-A-BRD-08: Radiosurgery Beyond Cancer: Real-Time Target Localization and Treatment Planning for Cardiac Radiosurgery Under MRI Guidance

Purpose: Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting >2.5M Americans and >4.5M Europeans. AF is usually treated with minimally-invasive, time consuming catheter ablation techniques. Radiosurgery of the pulmonary veins (PV) has been proposed for AF treatment, however is challenging due to the complex respiratory and cardiac motion patterns. We hypothesize that an MRI-linac could solve the difficult real-time targeting and adaptation problem. In this study we quantified target motion ranges on cardiac MRI and analyzed the dosimetric benefits of margin reduction assuming real-time MRI tracking was applied. Methods: For the motion study, four human subjects underwent real-time cardiac MRI under free breathing. The target motion on coronal and axial cine planes was analyzed using a template matching algorithm. For the planning study, an ablation line at each PV antrum was defined as target on an AF patient scheduled for catheter ablation. Various safety margins ranging from 0mm (perfect tracking) to 8mm (untracked motion) were added to the target defining the PTV. 30Gy single fraction IMRT plans were then generated. Finally, the influence of a 1T magnetic field on treatment beam delivery was calculated using the Geant4 Monte Carlo algorithm to simulate the dosimetric impact of MRI guidance. Results: The motion study showed the mean respiratory motion of the target area on MRI was 8.4mm (SI), 1.7mm (AP) and 0.3mm (LR). Cardiac motion was small (<2mm). The planning study showed that with increasing safety margins to encompass untracked motion, dose tolerances for OARs such as the esophagus and airways were exceeded by >100%. The magnetic field had little impact on the dose distribution. Conclusion: Our results indicate that real-time MRI tracking of the PVs seems feasible. Accurate image guidance for high-dose AF radiosurgery is essential since safety margins covering untracked target motion will result in unacceptable treatment plans.

60 APPLIED LIFE SCIENCES↗

MO-G-17A-09: Quantitative Autoradiography of Biopsy Specimens Extracted Under PET/CT Guidance

Purpose: To develop a procedure for accurate determination of PET tracer concentration with high spatial accuracy in situ by performing Quantitative Autoradiography of Biopsy Specimens (QABS) extracted under PET/CT guidance. Methods: Autoradiography (ARG) standards were produced from a gel loaded with a known concentration of FDG biopsied with 18G and 20G biopsy needles. Specimens obtained with these needles are generally cylindrical: up to 18 mm in length and about 0.8 and 0.6 mm in diameter respectively. These standards, with similar shape and density as biopsy specimens were used to generate ARG calibration curves.Quantitative ARG was performed to measure the activity concentration in biopsy specimens extracted from ten patients. The biopsy sites were determined according to PET/CT's obtained in the operating room. Additional CT scans were acquired with the needles in place to confirm correct needle placements. The ARG images were aligned with the needle tip in the PET/CT images using the open source CERR software. The mean SUV calculated from the specimen activities (SUVarg) were compared to that from PET (SUVpet) at the needle locations. Results: Calibration curves show that the relation between ARG signal and activity concentration in those standards is linear for the investigated range (up to 150 kBq/ml). The correlation coefficient of SUVarg with SUVpet is 0.74. Discrepancies between SUVarg and SUVpet can be attributed to the small size of the biopsy specimens compared to PET resolution. Conclusion: The calibration procedure using surrogate biopsy specimens provided a method for quantifying the activity within the biopsy cores obtained under FDG-PET guidance. QABS allows mapping the activity concentration in such biopsy specimens with a resolution of about 1mm. QABS is a promising tool for verification of biopsy adequacy by comparing specimen activity to that expected from the PET image. A portion of this research was funded by a research grant from Biospace Lab, 13 rue Georges Auric 75019 Paris, FRANCE.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

3D/3D registration of coronary CTA and biplane XA reconstructions for improved image guidance

Purpose: The authors aim to improve image guidance during percutaneous coronary interventions of chronic total occlusions (CTO) by providing information obtained from computed tomography angiography (CTA) to the cardiac interventionist. To this end, the authors investigate a method to register a 3D CTA model to biplane reconstructions. Methods: The authors developed a method for registering preoperative coronary CTA with intraoperative biplane x-ray angiography (XA) images via 3D models of the coronary arteries. The models are extracted from the CTA and biplane XA images, and are temporally aligned based on CTA reconstruction phase and XA ECG signals. Rigid spatial alignment is achieved with a robust probabilistic point set registration approach using Gaussian mixture models (GMMs). This approach is extended by including orientation in the Gaussian mixtures and by weighting bifurcation points. The method is evaluated on retrospectively acquired coronary CTA datasets of 23 CTO patients for which biplane XA images are available. Results: The Gaussian mixture model approach achieved a median registration accuracy of 1.7 mm. The extended GMM approach including orientation was not significantly different (P > 0.1) but did improve robustness with regards to the initialization of the 3D models. Conclusions: The authors demonstrated that the GMM approach can effectively be applied to register CTA to biplane XA images for the purpose of improving image guidance in percutaneous coronary interventions.

60 APPLIED LIFE SCIENCES↗

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

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

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SU-C-303-04: Evaluation of On- and Off-Line Bioluminescence Tomography System for Focal Irradiation Guidance

Purpose: We have developed offline and on-board bioluminescence tomography(BLT) systems for the small animal radiation research platform(SARRP) for radiation guidance of soft tissue targets. We investigated the effectiveness of offline BLT guidance. Methods: CBCT is equipped on both the offline BLT system and SARRP that are 10 ft. apart. To evaluate the setup error during animal transport between the two systems, we implanted a luminescence source in the abdomen of anesthetized mice. Five mice were studied. After CBCT was acquired on both systems, source centers and correlation coefficients were calculated. CBCT was also used to generate object mesh for BLT reconstruction. To assess target localization, we compared the localization of the luminescence source based on (1)on-board SARRP BLT and CBCT, (2)offline BLT and CBCT, and (3)offline BLT and SARRP CBCT. The 3rd comparison examines if an offline BLT system can be used to guide radiation when there is minimal target contrast in CBCT. Results: Our CBCT results show the offset of the light source center can be maintained within 0.2 mm during animal transport. The center of mass(CoM) of the light source reconstructed by the offline BLT has an offset of 1.0 ± 0.4 mm from the ‘true’ CoM as derived from the SARRP CBCT. The results compare well with the offset of 1.0 ± 0.2 mm using on-line BLT. Conclusion: With CBCT information provided by the SARRP and effective animal immobilization during transport, these findings support the use of offline BLT in close vicinity for accurate soft tissue target localization for irradiation. However, the disadvantage of the off-line system is reduced efficiency as care is required to maintain stable animal transport. We envisage a dual use system where the on-board arrangement allows convenient access to CBCT and avoids disturbance of animal setup. The off-line capability would support standalone longitudinal imaging studies. The work is supported by NIH R01CA158100 and Xstrahl Ltd. Drs. John Wong and Iulian Iordachita receive royalty payment from a licensing agreement between Xstrahl Ltd and Johns Hopkins University. John Wong also has a consultant agreement with Xstrahl Ltd.

60 APPLIED LIFE SCIENCES↗

SU-E-P-41: Imaging Coordination of Cone Beam CT, On-Board Image Conjunction with Optical Image Guidance for SBRT Treatment with Respiratory Motion Management

Purpose: To spare normal tissue for SBRT lung/liver patients, especially for patients with significant tumor motion, image guided respiratory motion management has been widely implemented in clinical practice. The purpose of this study was to evaluate imaging coordination of cone beam CT, on-board X-ray image conjunction with optical image guidance for SBRT treatment with motion management. Methods: Currently in our clinic a Varian Novlis Tx was utilized for treating SBRT patients implementing CBCT. A BrainLAB X-ray ExacTrac imaging system in conjunction with optical guidance was primarily used for SRS patients. CBCT and X-ray imaging system were independently calibrated with 1.0 mm tolerance. For SBRT lung/liver patients, the magnitude of tumor motion was measured based-on 4DCT and the measurement was analyzed to determine if patients would be beneficial with respiratory motion management. For patients eligible for motion management, an additional CT with breath holding would be scanned and used as primary planning CT and as reference images for Cone beam CT. During the SBRT treatment, a CBCT with pause and continuing technology would be performed with patients holding breath, which may require 3–4 partially scanned CBCT to combine as a whole CBCT depending on how long patients capable of holding breath. After patients being setup by CBCT images, the ExactTrac X-ray imaging system was implemented with patients’ on-board X-ray images compared to breath holding CT-based DRR. Results: For breath holding patients SBRT treatment, after initially localizing patients with CBCT, we then position patients with ExacTrac X-ray and optical imaging system. The observed deviations of real-time optical guided position average at 3.0, 2.5 and 1.5 mm in longitudinal, vertical and lateral respectively based on 35 treatments. Conclusion: The respiratory motion management clinical practice improved our physician confidence level to give tighter tumor margin for sparing normal tissue for SBRT lung/liver patients.

60 APPLIED LIFE SCIENCES↗

MO-DE-210-06: Development of a Supercompounded 3D Volumetric Ultrasound Image Guidance System for Prone Accelerated Partial Breast Irradiation (APBI)

Purpose: For early-stage breast cancer, accelerated partial breast irradiation (APBI) is a cost-effective breast-conserving treatment. Irradiation in a prone position can mitigate respiratory induced breast movement and achieve maximal sparing of heart and lung tissues. However, accurate dose delivery is challenging due to breast deformation and lumpectomy cavity shrinkage. We propose a 3D volumetric ultrasound (US) image guidance system for accurate prone APBI Methods: The designed system, set beneath the prone breast board, consists of a water container, an US scanner, and a two-layer breast immobilization cup. The outer layer of the breast cup forms the inner wall of water container while the inner layer is attached to patient breast directly to immobilization. The US transducer scans is attached to the outer-layer of breast cup at the dent of water container. Rotational US scans in a transverse plane are achieved by simultaneously rotating water container and transducer, and multiple transverse scanning forms a 3D scan. A supercompounding-technique-based volumetric US reconstruction algorithm is developed for 3D image reconstruction. The performance of the designed system is evaluated with two custom-made gelatin phantoms containing several cylindrical inserts filled in with water (11% reflection coefficient between materials). One phantom is designed for positioning evaluation while the other is for scaling assessment. Results: In the positioning evaluation phantom, the central distances between the inserts are 15, 20, 30 and 40 mm. The distances on reconstructed images differ by −0.19, −0.65, −0.11 and −1.67 mm, respectively. In the scaling evaluation phantom, inserts are 12.7, 19.05, 25.40 and 31.75 mm in diameter. Measured inserts’ sizes on images differed by 0.23, 0.19, −0.1 and 0.22 mm, respectively. Conclusion: The phantom evaluation results show that the developed 3D volumetric US system can accurately localize target position and determine target volume, and is a promising image-guidance tool for prone APBI.

60 APPLIED LIFE SCIENCES↗

WE-D-BRD-02: Tracking Coils for Brachy MR Guidance

The advantages that make MR highly desirable for in-room treatment guidance, i.e. soft-tissue visualization and physiological assessment of healthy/tumor tissues, are largely recognized in the research community. However, the MR absorption in practical clinical workflows is still hindered by lack of sufficient technological infrastructure. Recent advances have been made towards filling that gap such as the development of integrated therapy systems relying on an MR scanner and a radiation source (linac, Co-60) and/or brachytherapy. The session is intended to present new efforts and methods aimed at facilitating the adoption of MR guidance for treatment delivery. Specifically, the discussion will focus on a) linac designs for reduced footprint and seamless integration with MR/linac systems, b) tracking coils for brachytherapy applications, and c) procedures for the commissioning and monitoring of MR and MR/linac performance. Learning Objectives: Understand limitations and proposed solutions for linac designs and associated integration with MR/linac systems; Understand current issues with MR-guided brachytherapy procedures Understand the issues and needs for new MR commissioning and QC. License agreement with Modus Medical Devices to develop a phantom for the quantification of MR image distortions.

60 APPLIED LIFE SCIENCES↗

Volume of interest CBCT and tube current modulation for image guidance using dynamic kV collimation

Purpose: The focus of this work is the development of a novel blade collimation system enabling volume of interest (VOI) CBCT with tube current modulation using the kV image guidance source on a linear accelerator. Advantages of the system are assessed, particularly with regard to reduction and localization of dose and improvement of image quality. Methods: A four blade dynamic kV collimator was developed to track a VOI during a CBCT acquisition. The current prototype is capable of tracking an arbitrary volume defined by the treatment planner for subsequent CBCT guidance. During gantry rotation, the collimator tracks the VOI with adjustment of position and dimension. CBCT image quality was investigated as a function of collimator dimension, while maintaining the same dose to the VOI, for a 22.2 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Dose distributions were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field CBCT distributions to quantify dose reduction and localization to the target volume. A novel method of optimizing x-ray tube current during CBCT acquisition was developed and assessed with regard to contrast-to-noise ratio (CNR) and imaging dose. Results: Measurements show that the VOI CBCT method using the dynamic blade system yields an increase in contrast-to-noise ratio by a factor of approximately 2.2. Depending upon the anatomical site, dose was reduced to 15%–80% of the full-field CBCT value along the central axis plane and down to less than 1% out of plane. The use of tube current modulation allowed for specification of a desired SNR within projection data. For approximately the same dose to the VOI, CNR was further increased by a factor of 1.2 for modulated VOI CBCT, giving a combined improvement of 2.6 compared to full-field CBCT. Conclusions: The present dynamic blade system provides significant improvements in CNR for the same imaging dose and localization of imaging dose to a predefined volume of interest. The approach is compatible with tube current modulation, allowing optimization of the imaging protocol.

60 APPLIED LIFE SCIENCES↗

SU-G-JeP3-10: Update On a Real-Time Treatment Guidance System Using An IR Navigation System for Pleural PDT

Purpose: Photodynamic therapy (PDT) is used in conjunction with surgical debulking of tumorous tissue during treatment for pleural mesothelioma. One of the key components of effective PDT is uniform light distribution. Currently, light is monitored with 8 isotropic light detectors that are placed at specific locations inside the pleural cavity. A tracking system with real-time feedback software can be utilized to improve the uniformity of light in addition to the existing detectors. Methods: An infrared (IR) tracking camera is used to monitor the movement of the light source. The same system determines the pleural geometry of the treatment area. Software upgrades allow visualization of the pleural cavity as a two-dimensional volume. The treatment delivery wand was upgraded for ease of light delivery while incorporating the IR system. Isotropic detector locations are also displayed. Data from the tracking system is used to calculate the light fluence rate delivered. This data is also compared with in vivo data collected via the isotropic detectors. Furthermore, treatment volume information will be used to form light dose volume histograms of the pleural cavity. Results: In a phantom study, the light distribution was improved by using real-time guidance compared to the distribution when using detectors without guidance. With the tracking system, 2D data can be collected regarding light fluence rather than just the 8 discrete locations inside the pleural cavity. Light fluence distribution on the entire cavity can be calculated at every time in the treatment. Conclusion: The IR camera has been used successfully during pleural PDT patient treatment to track the motion of the light source and provide real-time display of 2D light fluence. It is possible to use the feedback system to deliver a more uniform dose of light throughout the pleural cavity.

60 APPLIED LIFE SCIENCES↗