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DOE OSTI2015

SU-E-J-216: A Sequence Independent Approach for Quantification of MR Image Deformations From Brachytherapy Applicators

Purpose: MRI is increasingly used as a single imaging modality for brachytherapy treatment planning. The presence of a brachytherapy applicator may cause distortions in the images, especially at higher field strengths. Our aim is to develop a procedure to quantify these distortions theoretically for any MR-sequence and to verify the estimated deformations for clinical sequences. Methods: Image distortions due to perturbation of the B0-field are proportional to the ratio of the induced frequency shift and the read-out bandwidth of the applied sequence. By reconstructing a frequency-shift map from the phase data from a multi-echo sequence, distortions can be calculated for any MR-sequence. Verification of this method for estimating distortions was performed by acquiring images with opposing read-out directions and consequently opposing distortions. The applicator shift can be determined by rigidly matching these images. Clinically, T2W-TSE-images are used for this purpose. For pre-clinical tests, EPI-sequences with narrow read-out bandwidth (19.5–47.5Hz), consequently large distortions, were added to the set of clinical MRsequences. To quantify deformations of the Utrecht Interstitial CT/MR applicator (Elekta Brachytherapy) on a Philips Ingenia 3T MRI, pre-clinical tests were performed in a phantom with the applicator in water, followed by clinical validation. Results: Deformations observed in the narrow bandwidth EPI-images were well predicted using the frequency-shift, the latter giving an overestimation up to 30%/up to 1 voxel. For clinically applied MR-sequences distortions were well below the voxel size. In patient setup distortions determined from the frequency-shift map were at sub-voxel level (<0.7mm). Using T2W-images larger distortions were found (1–2mm). This discrepancy was caused by patient movement between/during acquisition of the T2W-images with opposing read-out directions. Conclusion: Phantom experiments demonstrated the feasibility of a clinical procedure for quantification of MR-image distortions for any MR-sequence. In a clinical set-up the distortions from a Utrecht interstitial CT/MR applicator are sub-voxel level. This work was partially funded by Elekta Brachytherpy.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-92: Achieving Desirable Lung Doses in Total Body Irradiation Based On in Vivo Dosimetry and Custom Tissue Compensation

Purpose: To achieve desirable lung doses in total body irradiation (TBI) based on in vivo dosimetry and custom tissue compensation. Methods: The 15 MV photon beam of a Varian TrueBeam STx linac was used for TBI. Patients were positioned in the lateral decubitus position for AP/PA treatment delivery. Dose was calculated using the midpoint of the separation distance across the patient’s umbilicus. Patients received 200 cGy twice daily for 3 days. The dose rate at the patient’s midplane was approximately 10 cGy/min. Cerrobend blocks with a 5-HVL thickness were used for the primary lung shielding. A custom styrofoam holder for rice-flour filled bags was created based on the lung block cutouts. This was used to provide further lung shielding based on in vivo dose measurements. Lucite plates and rice-flour bags were placed in the head, neck, chest, and lower extremity regions during the treatment to compensate for the beam off-axis output variations. Two patients were included in the study. Patients 1 and 2 received a craniospinal treatment (1080 cGy) and a mediastinum treatment (2520 cGy), respectively, before the TBI. During the TBI nanoDot dosimeters were placed on the patient skin in the forehead, neck, umbilicus, and lung regions for dose monitoring. The doses were readout immediately after the treatment. Based on the readings, fine tuning of the thickness of the rice-flour filled bags was exploited to achieve the desirable lung doses. Results: For both patients the mean lung doses, which took into consideration all treatments, were controlled within 900 +/−10% cGy, as desired. Doses to the forehead, neck, and umbilicus were achieved within +/−10% of the prescribed dose (1200 cGy). Conclusion: A reliable and robust method was developed to achieve desirable lung doses and uniform body dose in TBI based on in vivo dosimetry and custom tissue compensator.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-386: Evaluation of EBT3 Film Response in Different Batches

Purpose: To investigate the uniformity of film response of EBT3 film of two different film batches. It has been reported that the response of the EBT film family is not homogenous between film batches. The later may have an impact in the dosimetry of small radiotherapy beams. Methods: A solid water phantom was used for dosimetric measurements. EBT3 film irradiation was performed with a 6 MV photon beam at 5 cm depth with a SAD of 100 cm. All irradiations were performed perpendicularly to the film plane covering the dose range 1 to 10 Gy. Three square field sizes were used to analyze the film response energy dependence: 10, 5 and 1 cm{sup 2}. Two batches of film EBT3 were used #A03181302 (B1) and #03031403 (B2). Film read out was carrying out with an Epson Perfection V750-Pro flatbed scanner in transmission mode with a spatial resolution of 72 dpi, with all post-processing and colour management options turned off, using 48 bits RGB colour depth. The scans were analyzed with the red channel. Results: The results shown that there were differences between the film response for each batch. The differences between batches for 1 Gy were 2%, 6% and 12% for 10, 5 and 1 cm2 square field sizes, respectively. The differences found for 10 Gy were 13%, 14% and 13% for 10, 5 and 1 cm{sup 2} square field sizes, respectively. It can be observed that the dependence with field size dismissed for higher doses. The later may be due to film response saturation at 10 Gy. Conclusion: The EBT3 film -as its predecessors-, it suffer for inter-batch variability in the film response. Further research is required to assess the possible impact in small beam dosimetry.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

SU-E-T-592: OSL Response of Al2O3:C Detectors Exposed to Therapeutic Proton Beams

Purpose: To characterize the response of Al{sub 2}O{sub 3}:C optically stimulated luminescence (OSL) detectors (OSLDs) exposed to therapeutic proton beams of differing beam quality. Methods: We prepared Al{sub 2}O{sub 3}:C OSLDs from the same material as commercially available nanoDot dosimeters (Landauer, Inc). We irradiated the OSLDs in modulated proton beams of varying quality, as defined by the residual range. An absorbed dose to water of 0.2 Gy was delivered to all OSLDs with the residual range values varying from 0.5 to 23.5 cm (average LET in water from ∼0.5 to 2.5 keV/µm). To investigate the beam quality dependence of different emission bands within the OSL spectrum, we performed OSLD readouts using both continuous-wave stimulation (CW-OSL) and pulsed stimulation (P-OSL) with two sets of optical filters (Hoya U-340 and Kopp 5113). For all readout modes, the relative absorbed dose sensitivity ( S{sub rel} ) for each beam quality was calculated using OSLDs irradiated in a 6 MV photon beam as a reference. Results: We found that the relative absorbed dose sensitivity was highly dependent on both readout mode and integration time of the OSL signal. For CW-OSL signals containing only the blue emission band, S{sub rel} was between 0.85 and 0.94 for 1 s readouts and between 0.82 and 0.93 for 10 s readouts. Similarly, for P-OSL readouts containing only the blue emission band S{sub rel} ranged from 0.86 to 0.91, and 0.82 to 0.93 for 1 s and 10 s readouts, respectively. For OSLD signals containing only the UV emission band, S{sub rel} ranged from 1.00 to 1.46, and 0.97 to 1.30 for P-OSL readouts of 1 s and 10 s, respectively. Conclusion: For measurements of absorbed dose using Al{sub 2}O{sub 3}:C OSLDs in therapeutic proton beams, dependence on beam quality was smallest for readout protocols that selected the blue emission band with small integration times. DA Granville received financial support from the Natural Sciences and Engineering Research Council of Canada.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

DOE OSTI2015

SU-E-T-675: Remote Dosimetry with a Novel PRESAGE Formulation

Purpose: 3D-gel dosimetry provides high-resolution treatment validation; however, scanners aren’t widely available. In remote dosimetry, dosimeters are shipped out from a central base institution to a remote site for irradiation, then shipped back for scanning and analysis, affording a convenient service for treatment validation to institutions lacking the necessary equipment and resources. Previous works demonstrated the high-resolution performance and temporal stability of PRESAGE. Here the newest formulation is investigated for remote dosimetry use. Methods: A new formulation of PRESAGE was created with the aim of improved color stability post irradiation. Dose sensitivity was determined by irradiating cuvettes on a Varian Linac (6MV) from 0–15Gy and measuring change in optical density at 633nm. Sensitivity readings were tracked over time in a temperature control study to determine long-term stability. A large volume study was performed to evaluate the accuracy for remote dosimetry. A 1kg dosimeter was pre-scanned, irradiated on-site with an 8Gy 4field box treatment, post-scanned and shipped to Princess Margaret Hospital for remote reading on an identical scanner. Results: Dose sensitivities ranged from 0.0194–0.0295 ΔOD/(Gy*cm)—similar to previous formulations. Post-irradiated cuvettes stored at 10°C retained 100% initial sensitivity over 5 days and 98.6% over 10 weeks while cuvettes stored at room temperature fell to 95.8% after 5 days and 37.4% after 10 weeks. The immediate and 5-day scans of the 4field box dosimeter data was reconstructed, registered to the corresponding eclipse dose-distribution, and compared with analytical tools in CERR. Immediate and 5-day scans looked visually similar. Line profiles revealed close agreement aside from a slight elevation in dose at the edge in the 5-day readout. Conclusion: The remote dosimetry formulation exhibits excellent temporal stability in small volumes. While immediate and 5-day readout scans of large volume dosimeters show promising agreement, further development is required to reduce an apparent time dependent edge elevation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2015

WE-AB-BRB-07: Alanine and Monte Carlo Determined Beam Quality Corrections for Nonstandard Fields of the Varian TrueBeam Accelerator

Purpose: To determine beam quality correction factors for flattened and unflattened beams of the Varian TrueBeam™ accelerator using alanine measurements and Monte Carlo calculations. Methods: Measurements were performed using L-α-alanine pellets encased in Virtual Water™ paddles. These were irradiated in liquid water using various field sizes of the 6MV and 10MV beam energies of the TrueBeam™, with both flattening-filter-free (FFF) and flattened beam modes. Measurements were also performed in a 10×10 cm{sup 2} {sup 60}Co field. Pellets were read out by the National Physical Laboratory (NPL, Teddington, UK) using electron paramagnetic resonance (EPR) spectrometry, and results were corrected for energy dependence using graphite calorimetry. Beam quality correction factors (k{sub Q}, k{sub Q}msr,Q, and k{sub Q}clin,Q{sub msr}) were determined for three ionization chambers: an Exradin A12 Farmer-type chamber, an Exradin A1SL scanning chamber, and an Exradin A26 microchamber. All chambers were modeled in the egs-chamber user code of EGSnrc. Sources were created using Varian-supplied IAEA-compliant phase spaces and the BEAMnrc user code, and were validated by comparing measured and simulated dose profiles. Results: Measured and calculated k{sub Q} values agreed within uncertainties, showing the chamber models to be reliable. A comparison of measured and calculated k{sub Q}msr,Q results with TG-51-based values showed that TG-51 adequately accounts for variations in beam quality between flattened and unflattened 10×10 cm{sup 2} fields. Small field corrections, k{sub Q}clin,Q{sub msr}, were determined to be up to 5%, referenced to a 10×10 cm{sup 2} field of the same energy and mode. Conclusion: Beam quality corrections were determined for several beam energies of the TrueBeam™ accelerator using Monte Carlo calculations and were validated using measurements with alanine. Values of k{sub Q} determined using TG-51 were found to be adequate for FFF reference fields. However, small field corrections are necessary for both flattened and unflattened beams to ensure greater treatment planning accuracy.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

DOE OSTI2015

WE-AB-204-04: Feature Selection and Clustering Optimization for Pseudo-CT Generation in MR-Based Attenuation Correction and Radiation Therapy Planning

Purpose: Accurate and robust photon attenuation derived from MR is essential for PET/MR and MR-based radiation treatment planning applications. Although the fuzzy C-means (FCM) algorithm has been applied for pseudo-CT generation, the input feature combination and the number of clusters have not been optimized. This study aims to optimize both for clinically practical pseudo-CT generation. Methods: Nine volunteers were recruited. A 190-second, single-acquisition UTE-mDixon with 25% (angular) sampling and 3D radial readout was performed to acquire three primitive MR features at TEs of 0.1, 1.5, and 2.8 ms: the free-induction-decay (FID), the first and the second echo images. Three derived images, Dixon-fat and Dixon-water generated by two-point Dixon water/fat separation, and R2* (1/T2*) map, were also created. To identify informative inputs for generating a pseudo-CT image volume, all 63 combinations, choosing one to six of the feature images, were used as inputs to FCM for pseudo-CT generation. Further, the number of clusters was varied from four to seven to find the optimal approach. Mean prediction deviation (MPD), mean absolute prediction deviation (MAPD), and correlation coefficient (R) of different combinations were compared for feature selection. Results: Among the 63 feature combinations, the four that resulted in the best MAPD and R were further compared along with the set containing all six features. The results suggested that R2* and Dixon-water are the most informative features. Further, including FID also improved the performance of pseudo-CT generation. Consequently, the set containing FID, Dixon-water, and R2* resulted in the most accurate, robust pseudo-CT when the number of cluster equals to five (5C). The clusters were interpreted as air, fat, bone, brain, and fluid. The six-cluster Result additionally included bone marrow. Conclusion: The results suggested that FID, Dixon-water, R2* are the most important features. The findings can be used to facilitate pseudo-CT generation for unsupervised clustering. Please note that the project was completed with partial funding from the Ohio Department of Development grant TECH 11-063 and a sponsored research agreement with Philips Healthcare that is managed by Case Western Reserve University. As noted in the affiliations, some of the authors are Philips employees.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

A novel synthetic single crystal diamond device for in vivo dosimetry

Purpose: Aim of the present work is to evaluate the synthetic single crystal diamond Schottky photodiode developed at the laboratories of “Tor Vergata” University in Rome in a new dosimeter configuration specifically designed for offline wireless in vivo dosimetry (IVD) applications. Methods: The new diamond based dosimeter, single crystal diamond detector (SCDD-iv), consists of a small unwired detector and a small external reading unit that can be connected to commercial electrometers for getting the detector readout after irradiation. Two nominally identical SCDD-iv dosimeter prototypes were fabricated and tested. A basic dosimetric characterization of detector performances relevant for IVD application was performed under irradiation with {sup 60}Co and 6 MV photon beams. Preirradiation procedure, response stability, short and long term reproducibility, leakage charge, fading effect, linearity with dose, dose rate dependence, temperature dependence, and angular response were investigated. Results: The SCDD-iv is simple, with no cables linked to the patient and the readout is immediate. The range of response with dose has been tested from 1 up to 12 Gy; the reading is independent of the accumulated dose and dose rate independent in the range between about 0.5 and 5 Gy/min; its temperature dependence is within 0.5% between 25 and 38 °C, and its directional dependence is within 2% from 0° to 90°. The combined relative standard uncertainty of absorbed dose to water measurements is estimated lower than the tolerance and action level of 5%. Conclusions: The reported results indicate the proposed novel offline dosimeter based on a synthetic single crystal diamond Schottky photodiode as a promising candidate for in vivo dosimetry applications with photon beams.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2015

Improved quality of intrafraction kilovoltage images by triggered readout of unexposed frames

Purpose: The gantry-mounted kilovoltage (kV) imager of modern linear accelerators can be used for real-time tumor localization during radiation treatment delivery. However, the kV image quality often suffers from cross-scatter from the megavoltage (MV) treatment beam. This study investigates readout of unexposed kV frames as a means to improve the kV image quality in a series of experiments and a theoretical model of the observed image quality improvements. Methods: A series of fluoroscopic images were acquired of a solid water phantom with an embedded gold marker and an air cavity with and without simultaneous radiation of the phantom with a 6 MV beam delivered perpendicular to the kV beam with 300 and 600 monitor units per minute (MU/min). An in-house built device triggered readout of zero, one, or multiple unexposed frames between the kV exposures. The unexposed frames contained part of the MV scatter, consequently reducing the amount of MV scatter accumulated in the exposed frames. The image quality with and without unexposed frame readout was quantified as the contrast-to-noise ratio (CNR) of the gold marker and air cavity for a range of imaging frequencies from 1 to 15 Hz. To gain more insight into the observed CNR changes, the image lag of the kV imager was measured and used as input in a simple model that describes the CNR with unexposed frame readout in terms of the contrast, kV noise, and MV noise measured without readout of unexposed frames. Results: Without readout of unexposed kV frames, the quality of intratreatment kV images decreased dramatically with reduced kV frequencies due to MV scatter. The gold marker was only visible for imaging frequencies ≥3 Hz at 300 MU/min and ≥5 Hz for 600 MU/min. Visibility of the air cavity required even higher imaging frequencies. Readout of multiple unexposed frames ensured visibility of both structures at all imaging frequencies and a CNR that was independent of the kV frame rate. The image lag was 12.2%, 2.2%, and 0.9% in the first, second, and third frame after an exposure. The CNR model predicted the CNR with triggered image readout with a mean absolute error of 2.0% for the gold marker. Conclusions: A device that triggers readout of unexposed frames during kV fluoroscopy was built and shown to greatly improve the quality of intratreatment kV images. A simple theoretical model successfully described the CNR improvements with the device.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

A self-powered thin-film radiation detector using intrinsic high-energy current

Purpose: The authors introduce a radiation detection method that relies on high-energy current (HEC) formed by secondary charged particles in the detector material, which induces conduction current in an external readout circuit. Direct energy conversion of the incident radiation powers the signal formation without the need for external bias voltage or amplification. The detector the authors consider is a thin-film multilayer device, composed of alternating disparate electrically conductive and insulating layers. The optimal design of HEC detectors consists of microscopic or nanoscopic structures. Methods: Theoretical and computational developments are presented to illustrate the salient properties of the HEC detector and to demonstrate its feasibility. In this work, the authors examine single-sandwiched and periodic layers of Cu and Al, and Au and Al, ranging in thickness from 100 nm to 300 μm and separated by similarly sized dielectric gaps, exposed to 120 kVp x-ray beam (half-value thickness of 4.1 mm of Al). The energy deposition characteristics and the high-energy current were determined using radiation transport computations. Results: The authors found that in a dual-layer configuration, the signal is in the measurable range. For a defined total detector thickness in a multilayer structure, the signal sharply increases with decreasing thickness of the high-Z conductive layers. This paper focuses on the computational results while a companion paper reports the experimental findings. Conclusions: Significant advantages of the device are that it does not require external power supply and amplification to create a measurable signal; it can be made in any size and geometry, including very thin (sub-millimeter to submicron) flexible curvilinear forms, and it is inexpensive. Potential applications include medical dosimetry (both in vivo and external), radiation protection, and other settings where one or more of the above qualities are desired.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

DOE OSTI2016

A combined time-of-flight and depth-of-interaction detector for total-body positron emission tomography

Purpose: In support of a project to build a total-body PET scanner with an axial field-of-view of 2 m, the authors are developing simple, cost-effective block detectors with combined time-of-flight (TOF) and depth-of-interaction (DOI) capabilities. Methods: This work focuses on investigating the potential of phosphor-coated crystals with conventional PMT-based block detector readout to provide DOI information while preserving timing resolution. The authors explored a variety of phosphor-coating configurations with single crystals and crystal arrays. Several pulse shape discrimination techniques were investigated, including decay time, delayed charge integration (DCI), and average signal shapes. Results: Pulse shape discrimination based on DCI provided the lowest DOI positioning error: 2 mm DOI positioning error was obtained with single phosphor-coated crystals while 3–3.5 mm DOI error was measured with the block detector module. Minimal timing resolution degradation was observed with single phosphor-coated crystals compared to uncoated crystals, and a timing resolution of 442 ps was obtained with phosphor-coated crystals in the block detector compared to 404 ps without phosphor coating. Flood maps showed a slight degradation in crystal resolvability with phosphor-coated crystals; however, all crystals could be resolved. Energy resolution was degraded by 3%–7% with phosphor-coated crystals compared to uncoated crystals. Conclusions: These results demonstrate the feasibility of obtaining TOF–DOI capabilities with simple block detector readout using phosphor-coated crystals.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

DOE OSTI2016

Maximum likelihood positioning algorithm for high-resolution PET scanners

Purpose: In high-resolution positron emission tomography (PET), lightsharing elements are incorporated into typical detector stacks to read out scintillator arrays in which one scintillator element (crystal) is smaller than the size of the readout channel. In order to identify the hit crystal by means of the measured light distribution, a positioning algorithm is required. One commonly applied positioning algorithm uses the center of gravity (COG) of the measured light distribution. The COG algorithm is limited in spatial resolution by noise and intercrystal Compton scatter. The purpose of this work is to develop a positioning algorithm which overcomes this limitation. Methods: The authors present a maximum likelihood (ML) algorithm which compares a set of expected light distributions given by probability density functions (PDFs) with the measured light distribution. Instead of modeling the PDFs by using an analytical model, the PDFs of the proposed ML algorithm are generated assuming a single-gamma-interaction model from measured data. The algorithm was evaluated with a hot-rod phantom measurement acquired with the preclinical HYPERION II {sup D} PET scanner. In order to assess the performance with respect to sensitivity, energy resolution, and image quality, the ML algorithm was compared to a COG algorithm which calculates the COG from a restricted set of channels. The authors studied the energy resolution of the ML and the COG algorithm regarding incomplete light distributions (missing channel information caused by detector dead time). Furthermore, the authors investigated the effects of using a filter based on the likelihood values on sensitivity, energy resolution, and image quality. Results: A sensitivity gain of up to 19% was demonstrated in comparison to the COG algorithm for the selected operation parameters. Energy resolution and image quality were on a similar level for both algorithms. Additionally, the authors demonstrated that the performance of the ML algorithm is less prone to missing channel information. A likelihood filter visually improved the image quality, i.e., the peak-to-valley increased up to a factor of 3 for 2-mm-diameter phantom rods by rejecting 87% of the coincidences. A relative improvement of the energy resolution of up to 12.8% was also measured rejecting 91% of the coincidences. Conclusions: The developed ML algorithm increases the sensitivity by correctly handling missing channel information without influencing energy resolution or image quality. Furthermore, the authors showed that energy resolution and image quality can be improved substantially by rejecting events that do not comply well with the single-gamma-interaction model, such as Compton-scattered events.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-E-02: A Feasibility Study for Application of Metal Artifact Reduction Techniques in MR-Guided Brachytherapy Gynecological Cancer with Titanium Applicators

Purpose: Utilization of Titanium Tandem and Ring (T&R) applicators in MR-guided brachytherapy has become widespread for gynecological cancer treatment. However, Titanium causes magnetic field disturbance and susceptibility artifact, which complicate image interpretation. In this study, metal artifact reduction techniques were employed to improve the image quality and reduce the metal related artifacts. Methods: Several techniques were employed to reduce the metal artifact caused by titanium T&R applicator. These techniques include Metal Artifact Reduction Sequence (MARS), View Angle Tilting (VAT) to correct in-plane distortion, and Slice Encoding for Metal Artifact Correction (SEMAC) for through-plane artifact correction. Moreover, MARS can be combined with VAT to further reduce the in-plane artifact by reapplying the selection gradients during the readout (MARS+VAT). SEMAC uses a slice selective excitation but acquires additional z-encodings in order to resolve off-resonant signal and to reduce through-plane distortions. Results: Comparison between the clinical sequences revealed that increasing the bandwidth reduces the error in measured diameter of T&R. However, the error is larger than 4mm for the best case with highest bandwidth and spatial resolution. MARS+VAT with isotropic resolution of 1mm reduced the error to 1.9mm which is the least among the examined 2D sequences. The measured diameter of tandem from SEMAC+VAT has the closest value to the actual diameter of tandem (3.2mm) and the error was reduced to less than 1mm. In addition, SEMAC+VAT significantly reduces the blooming artifact in the ring compared to clinical sequences. Conclusion: A higher bandwidth and spatial resolution sequence reduces the artifact and diameter of applicator with a slight compromise in SNR. Metal artifact reduction sequences decrease the distortion associated with titanium applicator. SEMAC+VAT sequence in combination with VAT revealed promising results for titanium imaging and can be utilized for MR-guided brachytherapy in gynecological cancer. The author is employee with Philips Healthcare.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-I-16: Short Breast MRI with High-Resolution T2-Weighted and Dynamic Contrast Enhanced T1-Weighted Images

Purpose: To develop and demonstrate a short breast (sb) MRI protocol that acquires both T2-weighted and dynamic contrast-enhanced T1-weighted images in approximately ten minutes. Methods: The sb-MRI protocol consists of two novel pulse sequences. The first is a flexible fast spin-echo triple-echo Dixon (FTED) sequence for high-resolution fat-suppressed T2-weighted imaging, and the second is a 3D fast dual-echo spoiled gradient sequence (FLEX) for volumetric fat-suppressed T1-weighted imaging before and post contrast agent injection. The flexible FTED sequence replaces each single readout during every echo-spacing period of FSE with three fast-switching bipolar readouts to produce three raw images in a single acquisition. These three raw images are then post-processed using a Dixon algorithm to generate separate water-only and fat-only images. The FLEX sequence acquires two echoes using dual-echo readout after each RF excitation and the corresponding images are post-processed using a similar Dixon algorithm to yield water-only and fat-only images. The sb-MRI protocol was implemented on a 3T MRI scanner and used for patients who had undergone concurrent clinical MRI for breast cancer screening. Results: With the same scan parameters (eg, spatial coverage, field of view, spatial and temporal resolution) as the clinical protocol, the total scan-time of the sb-MRI protocol (including the localizer, bilateral T2-weighted, and dynamic contrast-enhanced T1-weighted images) was 11 minutes. In comparison, the clinical breast MRI protocol took 43 minutes. Uniform fat suppression and high image quality were consistently achieved by sb-MRI. Conclusion: We demonstrated a sb-MRI protocol comprising both T2-weighted and dynamic contrast-enhanced T1-weighted images can be performed in approximately ten minutes. The spatial and temporal resolution of the images easily satisfies the current breast MRI accreditation guidelines by the American College of Radiology. The protocol has the potential of making breast MRI more widely accessible to and more tolerable by the patients. JMA is the inventor of United States patents that are owned by the University of Texas Board of Regents and currently licensed to GE Healthcare and Siemens Gmbh.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-76: Total Skin Electron Therapy: An-End-To-End Examination of the Absolute Dosimetry with a Rando Phantom

Purpose: To examine and validate the absolute dose for total skin electron therapy (TSET) through an end-to-end test with a Rando phantom using optically stimulated luminescent dosimeters (OSLDs) and EBT3 radiochromic films. Methods: A Varian Trilogy linear accelerator equipped with the special procedure 6 MeV HDTSe- was used to perform TSET irradiations using a modified Stanford 6-dual-field technique. The absolute dose was calibrated using a Markus ion chamber at a reference depth of 1.3cm at 100 cm SSD with a field size of 36 × 36 cm at the isocenter in solid water slabs. The absolute dose was cross validated by a farmer ion chamber. Then the dose rate in the unit of cGy/Mu was calibrated using the Markus chamber at the treatment position. OSLDs were used to independently verify the dose using the calibrated dose rate. Finally, a patient treatment plan (200 cGy/cycle) was delivered in the QA mode to a Rando phantom, which had 16 pairs of OSLDs and EBT3 films taped onto its surface at different anatomical positions. The doses recorded were read out to validate the absolute dosimetry for TSET. Results: The OSLD measurements were within 7% agreement with the planned dose except the shoulder areas, where the doses recorded were 23% lower on average than those of the planned. The EBT3 film measurements were within 10% agreement with the planned dose except the shoulder and the scalp vertex areas, where the respective doses recorded were 18% and 14% lower on average than those of the planned. The OSLDs gave more consistent dose measurements than those of the EBT3 films. Conclusion: The absolute dosimetry for TSET was validated by an end-to-end test with a Rando phantom using the OSLDs and EBT3 films. The beam calibration and monitor unit calculations were confirmed.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-324: Experimental Measurement of Optically Stimulated Luminescence Detectors in a MR-IGRT Environment Toward Assessing Magnetic Field Effects On These Devices and Their Use as An In-Vivo Dosimeter

Purpose: To characterize magnetic field effects on Optically Stimulated Luminescence Detectors (OSLDs) for use as an in-vivo dosimeter in an MRIGRT machine. Methods: Landauer OSLD nano-dots and the MicroStar II reader were used to measure and record OSLDs exposed in and on a solid water phantom in a 10.5 × 10.5 cm{sup 2} field, Co-60, 0.32-Tesla MR-IGRT machine - with and without the presence of the magnetic field. Two orthogonal gantry angles were considered to assess orientation effects on the OSLDs with respect to the incident angle of the radiation beam and magnetic field. The same OSLDs were then used (after readout and bleaching) when the magnetic field was restored. Results: The measured surface dose decreased by 14.1 ± 1.8% when magnetic field was ’on’ due to contamination electrons being swept away by the field. Doses at both 0.5 cm and 5 cm depth increased by 6.5 ± 0.9% and 8.8 ± 0.5% respectively when the magnetic field was present and the OSLDs oriented with their long axis parallel with the incident beam. This contrasts with an increased dose of 2.7 ± 1.1% when the magnetic field was present and the OSLDs were oriented with their long axis perpendicular to the incident beam. Conclusion: Previous works have shown that OSLDs have a dependence on beam incidence angle. Our current work suggests an additional dependence on the presence of the magnetic field when the beam is not perpendicular to the plane of the detector and this effect needs to be considered. Furthermore, the use of an in-vivo dosimeter was shown to have no effect on image quality during the use of MR guidance. Future work will focus on the use of an electromagnet with a linear accelerator to further characterize these effects.

60 APPLIED LIFE SCIENCES↗

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-488: Comparison of the TG-51 and TG-51 Addendum Calibration Protocols

Purpose: To quantify differences between the TG51 and TG51 addendum calibration protocols. Methods: Beam energies of 6X, 6XSRS, 10X, 15X, 23X, 6XFFF, and 10XFFF were calibrated following both the TG51 and TG51 addendum protocols using both a Farmer and a scanning ionization chamber with traceable absorbed dose-to-water calibrations. For the TG51 addendum procedure, the collimating jaws were positioned to define a 10×10cm{sup 2} radiation field, a lead foil was only used for kQ measurements of FFF energies, and a volume-averaging correction was applied based on crossline and inline dose profiles. For the TG51 procedure, the collimating jaws were set to 10×10cm{sup 2} according to the digital readout, and a lead foil was used for kQ measurements of energies greater than 10MV. Results: For beam energies with a flattening filter, absorbed dose-to-water determined by the two protocols differed by 0.1%–0.3%. For FFF beam energies, differences between the protocols were up to 0.2% and 0.8% for the scanning and Farmer ionization chambers, respectively. Differences between the protocols were due to kQ determination, volume-averaging correction, and measurement of raw ionization. Differences in kQ values between the two protocols were up to 0.4% and 0.2% for the scanning and Farmer ionization chambers, respectively. Volume-averaging corrections were less than 0.1% for the scanning ionization chamber, and up to 0.4% and 0.6% for the Farmer ionization chamber in beams with a flattening filter and FFF beams, respectively. Raw ionization measurements differed up to 0.3%±0.07% due to differences in jaw settings. Conclusion: The TG51 and TG51 addendum calibration protocols differed less than 0.3% for the scanning ionization chamber. For the Farmer chamber in FFF energies, volume-averaging corrections of up to 0.6% contributed to calibration differences of up to 0.8%. Failure to verify the radiation field size can produce calibration differences of up to 0.3%.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗