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At least 415 records · Page 23
All sourcesNASA NTRSDOE OSTI
DOE OSTI2016

SU-F-T-229: A Novel Method for EPID-Based In-Vivo Exit Dose Verification for Intensity Modulated Radiotherapy

Purpose: Electronic portal imaging device (EPID) can be used to acquire a two-dimensional exit dose distribution during treatment delivery, thus allowing the in-vivo verification of the dose delivery through a comparison of measured portal images to predicted portal dose images (PDI). The aim of this study was to present a novel method to easily and accurately predict PDI, and to establish an EPID-based in-vivo dose verification method during IMRT treatments. Methods: We developed a model to determine the predicted portal dose at the same plane of the EPID detector location. The Varian EPID (aS1000) positions at 150cm source-to-detector-distance (SDD), and can be used to acquire in-vivo exit dose using Portal Dosimetry (PD) function. Our model was generated to make an equivalent water thickness represent the buildup plate of EPID. The exit dose at extend SDD plane with patient CT data in the beam can be calculated as the predicted PDI in the treatment planning system (TPS). After that, the PDI was converted to the fluence at SDD of 150cm using the inverse square law coded in MATLAB. Five head-and-neck and prostate IMRT patient plans contain 32 fields were investigated to evaluate the feasibility of this new method. The measured EPID image was compared with PDI using the gamma analysis. Results: The average results for cumulative dose comparison were 81.9% and 91.6% for 3%, 3mm and 4%, 4mm gamma criteria, respectively. Results indicate that the patient transit dosimetry predicted algorithm compares well with EPID measured PD doses for test situations. Conclusion: Our new method can be used as an easy and feasible tool for online EPID-based in-vivo dose delivery verification for IMRT treatments. It can be implemented for fast detecting those obvious treatment delivery errors for individual field and patient quality assurance.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-259: GPR Tables for the Estimation of Mid-Plane Dose Using EPID

Purpose: To develop a simple method for estimating the mid-plane dose (MPD) of a patient using Electronic Portal imaging Device (EPID). Methods: A Varian TrueBeam with aSi100 EPID was used in this study. The EPID images were acquired for a 30 cm × 30 cm homogeneous slab phantom and a 30 cm diameter 20 cm thick cylindrical phantom in the continuous dosimetry mode. The acquired EPID images in XIM format were imported into in-house MATLAB program for the data analysis. First, the dosimetric characteristics of EPID were studied for dose-response linearity, dose-rate dependence, and field size dependence. Next, the average pixels values of the EPID images were correlated with the MPD measured by an ionisation chamber for various thicknesses of the slab phantom (8 cm – 30 cm) and for various square field sizes (3×3 cm{sup 2} – 25×25 cm{sup 2} at the isocenter). Look-up tables called as GPR tables were then generated for both SSD and SAD setup by taking the ratio of MPD measured by the ionisation chamber and the corresponding EPID pixel values. The accuracy of the GPR tables was evaluated by varying the field size, phantom thickness, and wedge angles with the slab and cylindrical phantoms. Results: The dose response of EPID was linear from 20 MU to 300 MU. The EPID response for different dose rates from 40 MU/min to 600 MU/min was within ±1%. The difference in the doses from the GPR tables and the doses measured by the ionization chambers were within 2% for slab phantoms, and 3% for the cylindrical phantom for various field sizes, phantom thickness, and wedge angles. Conclusion: GPR tables are a ready reckoner for in-vivo dosimetry and it can be used to quickly estimate the MPD value from the EPID images with an accuracy of ±3% for common clinical treatment. project work funded by Union for International cancer control(UICC) under ICRETT fellowship.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-263: Dosimetric Characteristics of the Cine Acquisition Mode of An A-Si EPID

Purpose: To investigate the dosimetric characteristics of Varian a-Si-500 electronic portal imaging device (EPID) operated in cine mode particularly considering linearity with delivered dose, dose rate, field size, phantom thickness, MLC speed and common IMRT fields. Methods: The EPID that attached to a Varian Clinac 21iX linear accelerator, was irradiated with 6 and 18 MV using 600 MU/min. Image acquisition is controlled by the IAS3 software, Trigger delay was 6 ms, BeamOnDelay and FrameStartDelay were zero. Different frame rates were utilized. Cine mode response was calculated using MATLAB as summation of mean pixel values in a region of interest of the acquired images. The performance of cine mode was compared to integrated mode and dose measurements in water using CC13 ionization chamber. Results: Figure1 illustrates that cine mode has nonlinear response for small MU, when delivering 10 MU was about 0.5 and 0.64 for 6 and 18 MV respectively. This is because the missing acquired images that were calculated around four images missing in each delivery. With the increase MU the response became linear and comparable with integrated mode and ionization chamber within 2%. Figure 2 shows that cine mode has comparable response with integrated mode and ionization chamber within 2% with changing dose rate for 10 MU delivered. This indicates that the dose rate change has no effect on nonlinearity of cine mode response. Except nonlinearity, cine mode is well matched to integrated mode response within 2% for field size, phantom thickness, MLC speed dependences. Conclusion: Cine mode has similar dosimetric characteristics to integrated mode with open and IMRT fields, and the main limitation with cine mode is missing images. Therefore, the calibration of EPID images with this mode should be run with large MU, and when IMRT verification field has low MU, the correction for missing images are required.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-282: Quality Assurance for IMRT/VMAT QA Devices: Issues Affecting the Timing for ArcCHECK Recalibration

Purpose: To discuss several factors surrounding the decision on when to recalibrate the ArcCHECK device as well as present a simple and efficient monthly check to evaluate ArcCHECK calibrations. Methods: ArcCheck (Sun Nuclear) calibrations were evaluated monthly by measuring a 25×25cm{sup 2} field with 100 MU. Since ArcCHECK measurements are run on an almost nightly basis, such additional square field measurements are obtained with minimal additional effort. An in-house MATLAB script compares two radial (y-direction) profiles from the top/center of the new measurement relative to a baseline measurement acquired at the last device calibration. The program automatically generates PDF profile and percent difference comparisons for inspection. Recalibration is based on inspection of measurement profile shapes and percent differences from the baseline measurement. Results: The method presented here shows the utility of a simple monthly check for evaluating ArcCHECK calibrations, and in addition shows the importance of recalibrating after Linac beam steering. Our device required recalibration approximately every 8–10 months. However, for ease of scheduling, we propose a bi-annual recalibration interval. Clinics with a lighter/heavier IMRT/VMAT QA case load may require different recalibration intervals, which are easily determined using the single-field method presented. Analysis of additional square fields is also easily incorporated, if desired. We further illustrate the importance of array recalibration given that diode irradiation is not uniform over the entire device, with central diodes receiving more than 900 Gy over the course of 10 months and peripheral diodes receiving as little as 50 Gy (in our experience). Finally, we show that timely device recalibration decreases spread in clinical IMRT/VMAT QA gamma passing rates. Conclusion: Quality assurance for ArcCHECK array calibrations is important to ensure quality IMRT/VMAT QA comparisons. For many clinics, calibrations should be performed at least annually, if not more frequently, based on use of the proposed monthly check.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-266: Dynalogs Based Evaluation of Different Dose Rate IMRT Using DVH and Gamma Index

Purpose: This work investigates the impact of low and high dose rate on IMRT through Dynalogs by evaluating Gamma Index and Dose Volume Histogram. Methods: The Eclipse™ treatment planning software was used to generate plans on prostate and head and neck sites. A range of dose rates 300 MU/min and 600 MU/min were applied to each plan in order to investigate their effect on the beam ON time, efficiency and accuracy. Each plan had distinct monitor units per fraction, delivery time, mean dose rate and leaf speed. The DVH data was used in the assessment of the conformity and plan quality.The treatments were delivered on Varian™ Clinac 2100C accelerator equipped with 120 leaf millennium MLC. Dynalogs of each plan were analyzed by MATLAB™ program. Fluence measurements were performed using the Sun Nuclear™ 2D diode array and results were assessed, based on Gamma analysis of dose fluence maps, beam delivery statistics and Dynalogs data. Results: Minor differences found by adjusted R-squared analysis of DVH’s for all the plans with different dose rates. It has been also found that more and larger fields have greater time reduction at high dose rate and there was a sharp decrease in number of control points observed in dynalog files by switching dose rate from 300 MU/min to 600 MU/min. Gamma Analysis of all plans passes the confidence limit of ≥95% with greater number of passing points in 300 MU/min dose rate plans. Conclusion: The dynalog files are compatible tool for software based IMRT QA. It can work perfectly parallel to measurement based QA setup and stand-by procedure for pre and post delivery of treatment plan.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-307: Peripheral Dose Comparison Between Static and Dynamic Jaw Tracking On a High Definition MLC System

Purpose: To investigate the effect of dynamic and static jaw tracking on patient peripheral doses. Materials and Methods: A patient plan with a large sacral metastasis (volume 800cm3, prescription 600cGyx5) was selected for this study. The plan was created using 2-field RapidArc with jaw tracking enabled (Eclipse, V11.0.31). These fields were then exported and edited in MATLAB with static jaw positions using the control point with the largest field size for each respective arc, but preserving the optimized leaf sequences for delivery. These fields were imported back into Eclipse for dose calculation and comparison and copied to a Rando phantom for delivery analysis. Points were chosen in the phantom at depth and on the phantom surface at locations outside the primary radiation field, at distances of 12cm, 20cm, and 30cm from the isocenter. Measurements were acquired with OSLDs placed at these positions in the phantom with both the dynamic and static jaw deliveries for comparison. Surface measurements included an additional 1cm bolus over the OSLDs to ensure electron equilibrium. Results: The static jaw deliveries resulted in cumulative jaw-defined field sizes of 17.3% and 17.4% greater area than the dynamic jaw deliveries for each arc. The static jaw plan resulted in very small differences in calculated dose in the treatment planning system ranging from 0–16cGy. The measured dose differences were larger than calculated, but the differences in absolute dose were small. The measured dose differences at depth (surface) between the two deliveries showed an increase for the static jaw delivery of 2.2%(11.4%), 15.6%(20.0%), and 12.7%(12.7%) for distances of 12cm, 20cm, and 30cm, respectively. Eclipse calculates a difference of 0–3.1% for all of these points. The largest absolute dose difference between all points was 6.2cGy. Conclusion: While we demonstrated larger than expected differences in peripheral dose, the absolute dose differences were small.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-315: Comparative Studies of Planar Dose with Different Spatial Resolution for Head and Neck IMRT QA

Purpose: To quantitatively investigate the planar dose difference and the γ value between the reference fluence map with the 1 mm detector-to-detector distance and the other fluence maps with less spatial resolution for head and neck intensity modulated radiation (IMRT) therapy. Methods: For ten head and neck cancer patients, the IMRT quality assurance (QA) beams were generated using by the commercial radiation treatment planning system, Pinnacle3 (ver. 8.0.d Philips Medical System, Madison, WI). For each beam, ten fluence maps (detector-to-detector distance: 1 mm to 10 mm by 1 mm) were generated. The fluence maps with larger than 1 mm detector-todetector distance were interpolated using MATLAB (R2014a, the Math Works,Natick, MA) by four different interpolation Methods: for the bilinear, the cubic spline, the bicubic, and the nearest neighbor interpolation, respectively. These interpolated fluence maps were compared with the reference one using the γ value (criteria: 3%, 3 mm) and the relative dose difference. Results: As the detector-to-detector distance increases, the dose difference between the two maps increases. For the fluence map with the same resolution, the cubic spline interpolation and the bicubic interpolation are almost equally best interpolation methods while the nearest neighbor interpolation is the worst.For example, for 5 mm distance fluence maps, γ≤1 are 98.12±2.28%, 99.48±0.66%, 99.45±0.65% and 82.23±0.48% for the bilinear, the cubic spline, the bicubic, and the nearest neighbor interpolation, respectively. For 7 mm distance fluence maps, γ≤1 are 90.87±5.91%, 90.22±6.95%, 91.79±5.97% and 71.93±4.92 for the bilinear, the cubic spline, the bicubic, and the nearest neighbor interpolation, respectively. Conclusion: We recommend that the 2-dimensional detector array with high spatial resolution should be used as an IMRT QA tool and that the measured fluence maps should be interpolated using by the cubic spline interpolation or the bicubic interpolation for head and neck IMRT delivery. This work was supported by Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (No. 2013M2A2A7038291)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-381: Fast Calculation of Three-Dimensional Dose Considering MLC Leaf Positional Errors for VMAT Plans

Purpose: In this study, we developed a system to calculate three dimensional (3D) dose that reflects dosimetric error caused by leaf miscalibration for head and neck and prostate volumetric modulated arc therapy (VMAT) without additional treatment planning system calculation on real time. Methods: An original system called clarkson dose calculation based dosimetric error calculation to calculate dosimetric error caused by leaf miscalibration was developed by MATLAB (Math Works, Natick, MA). Our program, first, calculates point doses at isocenter for baseline and modified VMAT plan, which generated by inducing MLC errors that enlarged aperture size of 1.0 mm with clarkson dose calculation. Second, error incuced 3D dose was generated with transforming TPS baseline 3D dose using calculated point doses. Results: Mean computing time was less than 5 seconds. For seven head and neck and prostate plans, between our method and TPS calculated error incuced 3D dose, the 3D gamma passing rates (0.5%/2 mm, global) are 97.6±0.6% and 98.0±0.4%. The dose percentage change with dose volume histogram parameter of mean dose on target volume were 0.1±0.5% and 0.4±0.3%, and with generalized equivalent uniform dose on target volume were −0.2±0.5% and 0.2±0.3%. Conclusion: The erroneous 3D dose calculated by our method is useful to check dosimetric error caused by leaf miscalibration before pre treatment patient QA dosimetry checks.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-399: Migration of Treatment Planning Systems Without Beam Data Measurement

Purpose: Data acquisition for commissioning is steered by Treatment Planning System (TPS) requirements which can be cumbersome and time consuming involving significant clinic downtime. The purpose of this abstract is to answer if we could circumvent this by extracting data from existing TPS and speed up the process. Methods: Commissioning beam data was obtained from a clinically commissioned TPS (Pinnacle™) using Matlab™ generated Pinnacle™ executable scripts to commission a secondary 3D dose verification TPS (Eclipse™). Profiles and output factors for commissioning as required by Eclipse™ were computed on a 50 cm{sup 3} water phantom at a dose grid resolution of 2mm3. Verification doses were computed and compared to clinical TPS dose profiles as per TG-106 guidelines. Standard patient plans from Pinnacle™ including IMRT and VMAT plans were re-computed keeping the same monitor units (in order to perform true comparison) using Eclipse™. Computed dose was exported back to Pinnacle for comparison to original plans. This methodology enables us to alleviate all ambiguities that arise in such studies. Results: Profile analysis using in-house software for 6x, showed that for all field sizes including small MLC generated fields, 100% of infield and penumbra data points of Eclipse™ match Pinnacle™ generated and measured profiles with 2%/2 mm gamma criteria. Excellent agreement was observed in the penumbra regions, with all data points passing DTA criteria for complex C-shaped and S-shaped profiles. Patient plan dose volume histograms (DVHs) and isodose lines agreed well to within a 1.5% for target coverage. Conclusion: Secondary 3D dose checking is of utmost importance with advanced techniques such as IMRT and VMAT. Migration of TPS is possible without compromising accuracy or enduring the cumbersome measurement of commissioning data. Economizing time for commissioning such a verification system or for migration of TPS can add great QA value and minimize downtime.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-428: An Optimization-Based Commissioning Tool for Finite Size Pencil Beam Dose Calculations

Purpose: Finite size pencil beam (FSPB) algorithms are commonly used to pre-calculate the beamlet dose distribution for IMRT treatment planning. FSPB commissioning, which usually requires fine tuning of the FSPB kernel parameters, is crucial to the dose calculation accuracy and hence the plan quality. Yet due to the large number of beamlets, FSPB commissioning could be very tedious. This abstract reports an optimization-based FSPB commissioning tool we have developed in MatLab to facilitate the commissioning. Methods: A FSPB dose kernel generally contains two types of parameters: the profile parameters determining the dose kernel shape, and a 2D scaling factors accounting for the longitudinal and off-axis corrections. The former were fitted using the penumbra of a reference broad beam’s dose profile with Levenberg-Marquardt algorithm. Since the dose distribution of a broad beam is simply a linear superposition of the dose kernel of each beamlet calculated with the fitted profile parameters and scaled using the scaling factors, these factors could be determined by solving an optimization problem which minimizes the discrepancies between the calculated dose of broad beams and the reference dose. Results: We have commissioned a FSPB algorithm for three linac photon beams (6MV, 15MV and 6MVFFF). Dose of four field sizes (6*6cm2, 10*10cm2, 15*15cm2 and 20*20cm2) were calculated and compared with the reference dose exported from Eclipse TPS system. For depth dose curves, the differences are less than 1% of maximum dose after maximum dose depth for most cases. For lateral dose profiles, the differences are less than 2% of central dose at inner-beam regions. The differences of the output factors are within 1% for all the three beams. Conclusion: We have developed an optimization-based commissioning tool for FSPB algorithms to facilitate the commissioning, providing sufficient accuracy of beamlet dose calculation for IMRT optimization.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2016

SU-F-T-434: Development of a Fan-Beam Optical Scanner Using CMOS Array for Small Field Dosimetry

Purpose: To design and construct a second generation optical computed tomography (OCT) system using a fan-beam with a CMOS array detector for the 3D dosimetry with polymer gel and radiochromic solid dosimeters. The system was specifically designed for the small field dosimetry. Methods: The optical scanner used a fan-beam laser, which was produced from a collimated red laser beam (λ=620 nm) with a 15-degree laser-line generating lens. The fan-beam was sent through an index-matching bath which holds the sample stage and a sample. The emerging laser light was detected with a 2.54 cm-long CMOS array detector (512 elements). The sample stage rotated through the full 360 degree projection angles at 0.9-degree increments. Each projection was normalized to the unirradiated sample at the projection angle to correct for imperfections in the dosimeter. A larger sample could be scanned by using a motorized mirror and linearly translating the CMOS detector. The height of the sample stage was varied for a full 3D scanning. The image acquisition and motor motion was controlled by a computer. The 3D image reconstruction was accomplished by a fan-beam reconstruction algorithm. All the software was developed inhouse with MATLAB. Results: The scanner was used on both PRESAGE and PAGAT gel dosimeters. Irreconcilable refraction errors were seen with PAGAT because the fan beam laser line refracted away from the detector when the field was highly varying in 3D. With PRESAGE, this type of error was not seen. Conclusion: We could acquire tomographic images of dose distributions by the new OCT system with both polymer gel and radiochromic solid dosimeters. Preliminary results showed that the system was more suited for radiochromic solid dosimeters since the radiochromic dosimeters exhibited minimal refraction and scattering errors. We are currently working on improving the image quality by thorough characterization of the OCT system.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-468: Efficient Scanning Data Analysis for TomoTherapy

Purpose: The standard TomoTherapy 2D scanning system requires manual analysis using spreadsheets or similar software. Manual analysis is time consuming and does not allow efficient use of the medical physicist or timely results that may indicate issues during the acquisition of data. The purpose of this study is to determine if an in-house solution can provide timely analysis of TomoTherapy scan data. Methods: A custom MATLAB program utilizing a streamlined graphical interface was developed to interpret the native scanning data acquired by the TomoTherapy Electrometer Measurement System (TEMS). The gold beam data provided by the manufacturer was used as a baseline for the acquired data. Two separate sets of scan data were used including longitudinal, transverse, and percent depth dose (PDD). The scan data were compared visually in an overlay and analytically for each beam width using the full width half max (FWHM) for longitudinal profiles and difference inside the field core for the transverse profiles as recommended by TG-148. A plot of the PDD percent error at each point along the curve was generated to show agreement. The time to analysis was measured on a laptop running an Intel i5 processor with 8GB of RAM. Results: The software program required on average less than 5 seconds to load and analyze the results. No conversion or reformatting of the data was required. This allowed real-time visualization of the comparison to the gold beam data as well as the parameters recommended by TG-148. The average percent difference was 0.3% for the longitudinal profiles and 0.1% for the transverse profiles. All PDD data was less than 1% different beyond dmax. Conclusion: We have developed a tool to analyze TomoTherapy scan data in real-time. This allows an efficient method to perform beam commissioning, annual QA, and adjust the beam parameters if necessary.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-T-477: Investigation of DEFGEL Dosimetry Using MRI

Purpose: The DEFGEL dosimeter/phantom allows for the measurement of 3D dose distributions while maintaining tissue equivalence and deformability. Although DEFGEL is traditionally read out with optical CT, the use of MRI would permit the measurement of 3D dose distributions in optically interfering configurations, like while embedded in a phantom. To the knowledge of the authors, this work is the first investigation that uses MRI to measure dose distributions in DEFGEL dosimeters. Methods: The DEFGEL (6%T) formula was used to create 1 cm thick, 4.5 cm diameter cylindrical dosimeters. The dosimeters were irradiated using a Varian Clinac 21EX linac. The MRI based transverse relaxation rate (R2) of the gel was measured in a central slice of the dosimeter with a Spin-Echo (SE) pulse sequence on a 3T GE SIGNA PET/MR scanner. The R2 values were fit to a monoexponential dose response equation using in-house software (MATLAB). Results: The data was well fit using a monoexponential fit for R2 as a function of absorbed dose (R{sup 2} = 0.9997). The fitting parameters of the monoexponential fit resulted in a 0.1229 Gy{sub −1}s{sub −1} slope. The data also resulted in an average standard deviation of 1.8% for the R2 values within the evaluated ROI. Conclusion: The close fit for the dose response curve shows that a DEFGEL based dosimeter can be paired with a SE MRI acquisition. The Type A uncertainty of the MRI method shows adequate precision, while the slope of the fit curve is large enough that R2 differences between different gel doses are distinguishable. These results suggest that the gel could potentially be used in configurations where an optical readout is not viable, such as measurements with the gel dosimeter positioned inside larger or optically opaque phantoms. This work is partially funded by NIH grant R01CA190298.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-540: Comprehensive Fluence Delivery Optimization with Multileaf Collimation

Purpose: Multileaf collimator (MLC) leaf sequencing is performed via commercial black-box implementations, on which a user has limited to no access. We have developed an explicit, generic MLC sequencing model to serve as a tool for future investigations of fluence map optimization, fluence delivery optimization, and rotational collimator delivery methods. Methods: We have developed a novel, comprehensive model to effectively account for a variety of transmission and penumbra effects previously treated on an ad hoc basis in the literature. As the model is capable of quantifying a variety of effects, we utilize the asymmetric leakage intensity across each leaf to deliver fluence maps with pixel size smaller than the narrowest leaf width. Developed using linear programming and mixed integer programming formulations, the model is implemented using state of the art open-source solvers. To demonstrate the versatility of the algorithm, a graphical user interface (GUI) was developed in MATLAB capable of accepting custom leaf specifications and transmission parameters. As a preliminary proof-ofconcept, we have sequenced the leaves of a Varian 120 Leaf Millennium MLC for five prostate cancer patient fields and one head and neck field. Predetermined fluence maps have been processed by data smoothing methods to obtain pixel sizes of 2.5 cm{sup 2}. The quality of output was analyzed using computer simulations. Results: For the prostate fields, an average root mean squared error (RMSE) of 0.82 and gamma (0.5mm/0.5%) of 91.4% were observed compared to RMSE and gamma (0.5mm/0.5%) values of 7.04 and 34.0% when the leakage considerations were omitted. Similar results were observed for the head and neck case. Conclusion: A model to sequence MLC leaves to optimality has been proposed. Future work will involve extensive testing and evaluation of the method on clinical MLCs and comparison with black-box leaf sequencing algorithms currently used by commercial treatment planning systems.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-556: A Potential Real Time AQA for Cyberknife Cones and MLC Based Treatments

Purpose: To investigate the potential use of the Raven™ (LAP of America Laser Applications) for real time AQA of Cyberknife™ with InCise2 MLC (Accuray™ Medical). Methods: At setup, the Raven was rotated 45° on which an Accuray™ AQA cube was positioned. Three different AQA plans for fixed cone, InCise2MLC, and a modified MLC plan were delivered repeatedly ten times. The additional shapes in modified AQA plan enable additional reproducibility checks for all the MLC pairs. During the test, the cube was aligned by imbedded fiducials and irradiated. The two angled radiation beams aimed center tungsten ball of the cube and projected 45° to phosphor screen and registered by a CCD camera of the Raven device. The centricity of the metal ball in the irradiated field was then analyzed using Matlab codes. Results: For AP images, the average offsets of X, Y, and radial directions are 0.24 ± 0.04 mm, 0.25 ± 0.02 mm and 0.35 ±± 0.03 mm respectively for the cone; 0.34 ± 0.02 mm, 0.49 ± 0.04 mm and 0.60 ± 0.04 mm respectively for the MLC. For lateral images, they are 0.63 ± 0.05 mm, 0.11 ± 0.02 mm and 0.64 ± 0.04 mm respectively for the cone, 0.79 ± 0.08 mm, −0.23 ± 0.06 mm and 0.82 ± 0.09 mm respectively for the MLC. No inconsistent MLC shapes were found in the modified AQA group. Conclusion: The results are consistent with clinically acceptable values (≤1mm from baseline). The results suggest the potential of replacement of the standard AQA test with the novel real-time Raven device for Cyberknife daily QA. The modified MLC based AQA provides a more comprehensive MLC daily QA capability. Further improvements in its resolution and automatic analyzing capability are warranted.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-563: Delivered Dose Reconstruction of Moving Targets for Gated Volumetric Modulated Arc Therapy (VMAT)

Purpose: Actual delivered dose of moving tumors treated with gated volumetric arc therapy (VMAT) may significantly differ from the planned dose assuming static target. In this study, we developed a method which reconstructs actual delivered dose distribution of moving target by taking into account both tumor motion and dynamic beam delivery of gated VMAT, and applied to abdominal tumors. Methods: Fifteen dual-arc VMAT plans (Eclipse, Varian Medical Systems) for 5 lung, 5 pancreatic, and 5 liver cancer patients treated with gated VMAT stereotactic body radiotherapy (SBRT) were studied. For reconstruction of the delivered dose distribution, we divided each original arc beam into control-point-wise sub-beams, and applied beam isocenter shifting to each sub-beam to reflect the tumor motion. The tumor positions as a function of beam delivery were estimated by synchronizing the beam delivery with the respiratory signal which acquired during treatment. For this purpose, an in-house program (MATLAB, Mathworks) was developed to convert the original DICOM plan data into motion-involved treatment plan. The motion-involved DICOM plan was imported into Eclipse for dose calculation. The reconstructed delivered dose was compared to the plan dose using the dose coverage of gross tumor volume (GTV) and dose distribution of organs at risk (OAR). Results: The mean GTV dose coverage difference between the reconstructed delivered dose and the plan dose was 0.2 % in lung and pancreas cases, and no difference in liver cases. Mean D1000cc of ipsilateral lungs was reduced (0.8 ± 1.4cGy). Conclusion: We successfully developed a method of delivered dose reconstruction taking into account both respiratory tumor motion and dynamic beam delivery, and applied it to abdominal tumors treated with gated VAMT. No significant deterioration of delivered dose distribution indicates that interplay effect would be minimal even in the case of gated SBRT. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2015038710)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-662: Feasibility Study of Fe3O4/TaOx Nano Particles as a Radiosensitizer for Radiation Therapy

Purpose: To investigate the feasibility of using multifunctional Fe{sub 3}O{sub 4}/TaOx(core / shell) nano particles developed for CT and MRI contrast agent as dose enhancing radiosensitizers. Methods: Firstly, to verify the imaging detectability of Fe{sub 3}O{sub 4}/TaOx nano particles, in-vivo tests were conducted. Approximately 600 mg/kg of 19 nm diameter Fe{sub 3}O{sub 4}/TaOx nano particles dispersed in phosphate buffered saline(PBS) were injected to ten nude Balb/c mice through the tail vein. Difference between pre- and post-injection images was analyzed by computing the pixel histogram and correlation coefficient factor using MATLAB in the user defined ROI. Secondly, to quantify the potential therapeutic enhancement with nano materials, DER (Dose Enhancement Ratio) and number of SER (Secondary Electron Ratio) were computed using TOPAS(ver.2.0 P-03) MC simulation. Results: In CT, MRI imaging, the aorta, the blood vessel, and the liver were clearly visualized after intravenous injection of Fe{sub 3}O{sub 4}/TaOx nano particles. There was large different between pre and post-injection images of Histogram data and Coefficients of correlation factor in CT and MR are 0.006, 0.060, respectively. When 70 MeV protons were irradiated for a Gold, Tantalum, TaOx, Fe{sub 3}O{sub 4}/TaOx, Fe{sub 3}O{sub 4} nano particle, DER was 2.59, 2.41, 1.68, 1.54 and 1.36 respectively. Similarly, SER increment was 2.31, 2.15, 1.56, 1.46, and 1.27 for Gold, Tantalum, TaOx, Fe{sub 3}O{sub 4}/TaOx, Fe{sub 3}O{sub 4} nano particle, respectively. Conclusion: Fe{sub 3}O{sub 4}/TaOx nano particles have potential as a multifunctional agent which enhances the accuracy in cancer detection through visualization of developed tumor lesion and increases the therapeutic effect in proton therapy. The dose enhancement with Fe{sub 3}O{sub 4}/TaOx was estimated as half of the Gold. However, tumor targeting such as combined with magnetic field may overcome the low DER. This research was supported by the NRF funded by the Ministry of Science, ICT & Future Planning (2012M3A9B6055201 and 2012R1A1A2042414), Samsung Medical Center grant[GFO1130081].

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-G-BRA-02: Development of a Learning Based Block Matching Algorithm for Ultrasound Tracking in Radiotherapy

Purpose: To develop an ultrasound learning-based tracking algorithm with the potential to provide real-time motion traces of anatomy-based fiducials that may aid in the effective delivery of external beam radiation. Methods: The algorithm was developed in Matlab R2015a and consists of two main stages: reference frame selection, and localized block matching. Immediately following frame acquisition, a normalized cross-correlation (NCC) similarity metric is used to determine a reference frame most similar to the current frame from a series of training set images that were acquired during a pretreatment scan. Segmented features in the reference frame provide the basis for the localized block matching to determine the feature locations in the current frame. The boundary points of the reference frame segmentation are used as the initial locations for the block matching and NCC is used to find the most similar block in the current frame. The best matched block locations in the current frame comprise the updated feature boundary. The algorithm was tested using five features from two sets of ultrasound patient data obtained from MICCAI 2014 CLUST. Due to the lack of a training set associated with the image sequences, the first 200 frames of the image sets were considered a valid training set for preliminary testing, and tracking was performed over the remaining frames. Results: Tracking of the five vessel features resulted in an average tracking error of 1.21 mm relative to predefined annotations. The average analysis rate was 15.7 FPS with analysis for one of the two patients reaching real-time speeds. Computations were performed on an i5-3230M at 2.60 GHz. Conclusion: Preliminary tests show tracking errors comparable with similar algorithms at close to real-time speeds. Extension of the work onto a GPU platform has the potential to achieve real-time performance, making tracking for therapy applications a feasible option. This work is partially funded by NIH grant R01CA190298.

60 APPLIED LIFE SCIENCES↗