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At least 451 records · Page 25

SU-E-T-514: Investigating the Dose Distributions of Equiangular Spaced Noncoplanar Beams

Purpose It has been demonstrated that the use of noncoplanar beams in radiation therapy may Result in dose distributions that are comparable or better than standard coplanar beams [Pugachev, 2001]. A radiation therapy system designed with a noncoplanar beam geometry could allow for a full ring diagnostic quality imaging system to be placed around the patient. Additionally, if the noncoplanar beams were fixed in number and in their angle with respect to the patient’s axial plane, then both treatment and imaging could be achieved concurrently without the need for moving parts, which could greatly reduce treatment times. For such a system to be designed, it is necessary to determine the appropriate number of beams and the beam angles to achieve optimal dose distributions. For simplicity, the beam angles are assumed to be equiangular in the patient’s axial plane, and only the beam angle with respect to the axial plane are varied. This study aims to investigate the dose distributions produced by equiangular noncoplanar beams for multiple beam numbers and beam angles, and to compare these dose distributions with distributions achieved in coplanar volumetric arc therapy (VMAT). Methods Dose distributions produced by noncoplanar beams were calculated using the Varian Eclipse treatment planning system by varying the gantry, collimator, and couch angles to simulate the noncoplanar delivery method. Noncoplanar intensity-modulated (NC-IMRT) beams using 8, 12, and 16 beams with angles varying from 45 degrees to 54 with respect to the patient’s axial plane were studied. Results The NC-IMRT beams produced dose distributions comparable to VMAT plans for a number of treatment sites, and were capable of meeting similar dose-volume histogram constraints. Conclusion This study has demonstrated that a noncoplanar beam delivery method with fixed beam numbers and beam angles is capable of delivering dose distributions comparable to VMAT plans currently in use.

60 APPLIED LIFE SCIENCES↗

WE-AB-213-01: AAPM Projects and Collaborations in Africa

AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such as Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.

60 APPLIED LIFE SCIENCES↗

WE-AB-213-02: Status of Medical Physics Collaborations, and Projects in Latin America

AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such as Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.

60 APPLIED LIFE SCIENCES↗

WE-AB-213-03: Challenges and Opportunities

AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such as Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.

60 APPLIED LIFE SCIENCES↗

WE-AB-213-04: IAEA Support to Medical Physics in Africa and Latin America: Achievements and Challenges

AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such as Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.

60 APPLIED LIFE SCIENCES↗

WE-AB-213-05: Closing Remarks

AAPM projects and collaborations in Africa Adam Shulman (AA-SC Chair) The African Affairs Subcommittee (AA-SC) of the AAPM will present a multi-institutional approach to medical physics support in Africa. Current work to increase the quality of care and level of safety for the medical physics practice in Senegal, Ghana, and Zimbabwe will be presented, along with preliminary projects in Nigeria and Botswana. Because the task of addressing the needs of medical physics in countries across Africa is larger than one entity can accomplish on its own, the AA-SC has taken the approach of joining forces with multiple organizations such as Radiating Hope and TreatSafely (NGO’s), the IAEA, companies like BrainLab, Varian and Elekta, medical volunteers and academic institutions such as NYU and Washington University. Elements of current projects include: 1) Distance training and evaluation of the quality of contouring and treatment planning, teaching treatment planning and other subjects, and troubleshooting using modern telecommunications technology in Senegal, Ghana, and Zimbabwe; 2) Assistance in the transition from 2D to 3D in Senegal and Zimbabwe; 3) Assistance in the transition from 3D to IMRT using in-house compensators in Senegal; 4) Modernizing the cancer center in Senegal and increasing safety and; 5) Training on on 3D techniques in Ghana; 6) Assisting a teaching and training radiation oncology center to be built in Zimbabwe; 7) Working with the ISEP Program in Sub-Saharan Africa; 8) Creating instructional videos on linac commissioning; 9) Working on a possible collaboration to train physicists in Nigeria. Building on past achievements, the subcommittee seeks to make a larger impact on the continent, as the number and size of projects increases and more human resources become available. The State of Medical Physics Collaborations and Projects in Latin America Sandra Guzman (Peru) The lack of Medical Physicists (MP) in many Latin American (LA) countries leads to recruitment of professionals with incomplete education. In most LA countries only one MP responsible for each Center is currently mandated. Currently there is a large disparity among MP training programs and there is significant debate about the standards of MP graduate education in many LA countries. There are no commonly recognized academic programs, not enough clinical training sites and clinical training is not typically considered as part of the MP work. Economic pressures and high workloads also impede the creation of more training centers. The increasing need of qualified MPs require establishing a coordinated system of national Education & Training Centers (ETC), to meet the international standards of education and training in Medical Physics. This shortfall calls for support of organizations such as the IOMP, AAPM, ALFIM, IAEA, etc. Examples from various LA countries, as well as some proposed solutions, will be presented. In particular, we will discuss the resources that the AAPM and its members can offer to support regional programs. The ‘Medical Imaging’ physicist in the emerging world: Challenges and opportunities - Caridad Borrás (WGNIMP Chair) While the role of radiation therapy physicists in the emerging world is reasonably well established, the role of medical imaging physicists is not. The only perceived needs in radiology departments are equipment quality control and radiation protection, tasks that can be done by a technologist or a service engineer. To change the situation, the International Basic Safety Standard, which is adopted/adapted world-wide as national radiation protection regulations, states: “For diagnostic radiological procedures and image guided interventional procedures, the requirements of these Standards for medical imaging, calibration, dosimetry and quality assurance, including the acceptance and commissioning of medical radiological equipment, are fulfilled by or under the oversight of, or with the documented advice of a medical physicist, whose degree of involvement is determined by the complexity of the radiological procedures and the associated radiation risks”. Details on how these requirements can be carried out in resource-limited settings will be described. IAEA support to medical physics in Africa and Latin America: achievements and challenges Ahmed Meghzifene (IAEA) Shortage of clinically qualified medical physicists in radiotherapy and imaging, insufficient and inadequate education and training programs, as well as a lack of professional recognition were identified as the main issues to be addressed by the IAEA. The IAEA developed a series of integrated projects aiming specifically at promoting the essential role of medical physicists in health care, developing harmonized guidelines on dosimetry and quality assurance, and supporting education and clinical training programs. The unique feature of the IAEA approach is support it provides for implementation of guidelines and education programs in Member States through its technical cooperation project. The presentation will summarize IAEA support to Latin America and Africa in the field of medical physics and will highlight how the new International Basic Safety Standards are expected to impact the medical physics practice in low and middle income countries. Learning Objectives: Learn about the shortage of qualified Medical Physicists in Africa and Latin America. Understand the reasons of this shortage. Learn about the ways to improve the situation and AAPM role in this process.

60 APPLIED LIFE SCIENCES↗

TU-CD-BRB-02: BEST IN PHYSICS (JOINT IMAGING-THERAPY): Identification of Molecular Phenotypes by Integrating Radiomics and Genomics

Purpose: To uncover the mechanistic connections between radiomic features, molecular pathways, and clinical outcomes, to develop radiomic based predictors of pathway activation states in individual patients, and to assess whether combining radiomic with clinical and genomic data improves prognostication. Methods: We analyzed two independent lung cancer cohorts totaling 351 patients, for whom diagnostic computed tomography (CT) scans, gene-expression profiles, and clinical outcomes were available. The tumor phenotype was characterized based on 636 radiomic features describing tumor intensity, texture, shape and size. We performed an integrative analysis by developing and independently validating association modules of coherently expressed radiomic features and molecular pathways. These modules were statistically tested for significant associations to overall survival (OS), TNM stage, and pathologic histology. Results: We identified thirteen radiomic-pathway association modules (p < 0.05), the most prominent of which were associated with the immune system, p53 pathway, and other pathways involved in cell cycle regulation. Eleven modules were significantly associated with clinical outcomes (p < 0.05). Strong predictive power for pathway activation states in individual patients was observed using radiomics; the strongest per module predictions ranged from an intra-tumor heterogeneity feature predicting RNA III polymerase transcription (AUC 0.62, p = 0.03), to a tumor intensity dispersion feature predicting pyruvate metabolism and citric acid TCA cycle (AUC 0.72, p < 10−{sup 6}). Stepwise combinations of radiomic data with clinical outcomes and gene expression profiles resulted in consistent increases of prognostic power to predict OS (concordance index max = 0.73, p < 10−{sup 9}). Conclusion: This study demonstrates that radiomic approaches permit a non-invasive assessment of molecular and clinical characteristics of tumors, and therefore have the unprecedented potential to cost-effectively advance clinical decision-making using routinely acquired, standard-of-care imaging data. We show that prognostic value complementary to clinical and genomic information can be obtained by radiomic strategies.

60 APPLIED LIFE SCIENCES↗

SU-F-R-05: Multidimensional Imaging Radiomics-Geodesics: A Novel Manifold Learning Based Automatic Feature Extraction Method for Diagnostic Prediction in Multiparametric Imaging

Purpose: Multiparametric radiological imaging is used for diagnosis in patients. Potentially extracting useful features specific to a patient’s pathology would be crucial step towards personalized medicine and assessing treatment options. In order to automatically extract features directly from multiparametric radiological imaging datasets, we developed an advanced unsupervised machine learning algorithm called the multidimensional imaging radiomics-geodesics(MIRaGe). Methods: Seventy-six breast tumor patients underwent 3T MRI breast imaging were used for this study. We tested the MIRaGe algorithm to extract features for classification of breast tumors into benign or malignant. The MRI parameters used were T1-weighted, T2-weighted, dynamic contrast enhanced MR imaging (DCE-MRI) and diffusion weighted imaging(DWI). The MIRaGe algorithm extracted the radiomics-geodesics features (RGFs) from multiparametric MRI datasets. This enable our method to learn the intrinsic manifold representations corresponding to the patients. To determine the informative RGF, a modified Isomap algorithm(t-Isomap) was created for a radiomics-geodesics feature space(tRGFS) to avoid overfitting. Final classification was performed using SVM. The predictive power of the RGFs was tested and validated using k-fold cross validation. Results: The RGFs extracted by the MIRaGe algorithm successfully classified malignant lesions from benign lesions with a sensitivity of 93% and a specificity of 91%. The top 50 RGFs identified as the most predictive by the t-Isomap procedure were consistent with the radiological parameters known to be associated with breast cancer diagnosis and were categorized as kinetic curve characterizing RGFs, wash-in rate characterizing RGFs, wash-out rate characterizing RGFs and morphology characterizing RGFs. Conclusion: In this paper, we developed a novel feature extraction algorithm for multiparametric radiological imaging. The results demonstrated the power of the MIRaGe algorithm at automatically discovering useful feature representations directly from the raw multiparametric MRI data. In conclusion, the MIRaGe informatics model provides a powerful tool with applicability in cancer diagnosis and a possibility of extension to other kinds of pathologies. NIH (P50CA103175, 5P30CA006973 (IRAT), R01CA190299, U01CA140204), Siemens Medical Systems (JHU-2012-MR-86-01) and Nivida Graphics Corporation.

60 APPLIED LIFE SCIENCES↗

SU-G-TeP2-05: Development of a Thimble Calorimeter for Absorbed Dose to Water Characterized in MV Photons

Purpose: To develop a thimble sized polystyrene calorimeter for use from kV to MV photons, as a primary reference standard for applications from diagnostic CT imaging to therapy beam dose determination. Methods: A polystyrene calorimeter about 1.5 cm diameter embedded with small thermistors was characterized in a 6 MV photon beam from a clinical accelerator at 5 nominal dose rates from 0.8 to 4 Gy/min. Irradiations were delivered with beam on/off cycles first at 60 s and then at 20 s. Two sets of phantom conditions were evaluated: 1) in a 30 cm diameter polyethylene cylinder, and 2) in 10 cm depth of a 30 cm water phantom. The temperature waveforms were recorded and analyzed for temperature rise, arriving at a dose to polystyrene. This value is compared with the result of measurements under identical conditions using an ionization chamber calibrated for absorbed dose to water. Monte Carlo simulations were performed on the measurement systems to estimate such a ratio. Results: The ratio of the dose determined by the calorimeter to the dose reported by the ionization chamber was aggregated from all 5 dose rates. The 60 s results show a much elevated response in both phantoms compared to their respective expected results based on simulation. This deviation was reduced when the on/off cycles were shortened to 20 s. This behavior was possibly due to the heat conduction effects in the small calorimeter body. Finite element modeling is being conducted to simulate this effect. Conclusion: A small solid plastic calorimeter offers the convenience of a portable absorbed dose standard based on direct measurement of energy deposition, but comes at the expense of heat transfer complications which need to be characterized. This work offers preliminary evidence of the behavior and quantitative assessment of the issues to be resolved in future investigations.

60 APPLIED LIFE SCIENCES↗

TU-CD-207-05: A Novel Digital Tomosynthesis System Using Orthogonal Scanning Technique: A Feasibility Study

Purpose: As an alternative to full tomographic imaging technique such as cone-beam computed tomography (CBCT), there is growing interest to adopt digital tomosynthesis (DTS) for the use of diagnostic as well as therapeutic applications. The aim of this study is to propose a new DTS system using novel orthogonal scanning technique, which can provide superior image quality DTS images compared to the conventional DTS scanning system. Methods: Unlike conventional DTS scanning system, the proposed DTS is reconstructed with two sets of orthogonal patient scans. 1) X-ray projections that are acquired along transverse trajectory and 2) an additional sets of X-ray projections acquired along the vertical direction at the mid angle of the previous transverse scan. To reconstruct DTS, we have used modified filtered backprojection technique to account for the different scanning directions of each projection set. We have evaluated the performance of our method using numerical planning CT data of liver cancer patient and a physical pelvis phantom experiment. The results were compared with conventional DTS techniques with single transverse and vertical scanning. Results: The experiments on both numerical simulation as well as physical experiment showed that the resolution as well as contrast of anatomical structures was much clearer using our method. Specifically, the image quality comparing with transversely scanned DTS showed that the edge and contrast of anatomical structures along Left-Right (LR) directions was comparable however, considerable discrepancy and enhancement could be observed along Superior-Inferior (SI) direction using our method. The opposite was observed when vertically scanned DTS was compared. Conclusion: In this study, we propose a novel DTS system using orthogonal scanning technique. The results indicated that the image quality of our novel DTS system was superior compared to conventional DTS system. This makes our DTS system potentially useful in various on-line clinical applications.

60 APPLIED LIFE SCIENCES↗

SU-F-J-178: A Computer Simulation Model Observer for Task-Based Image Quality Assessment in Radiation Therapy

Purpose: Traditionally, image quality in radiation therapy is assessed subjectively or by utilizing physically-based metrics. Some model observers exist for task-based medical image quality assessment, but almost exclusively for diagnostic imaging tasks. As opposed to disease diagnosis, the task for image observers in radiation therapy is to utilize the available images to design and deliver a radiation dose which maximizes patient disease control while minimizing normal tissue damage. The purpose of this study was to design and implement a new computer simulation model observer to enable task-based image quality assessment in radiation therapy. Methods: A modular computer simulation framework was developed to resemble the radiotherapy observer by simulating an end-to-end radiation therapy treatment. Given images and the ground-truth organ boundaries from a numerical phantom as inputs, the framework simulates an external beam radiation therapy treatment and quantifies patient treatment outcomes using the previously defined therapeutic operating characteristic (TOC) curve. As a preliminary demonstration, TOC curves were calculated for various CT acquisition and reconstruction parameters, with the goal of assessing and optimizing simulation CT image quality for radiation therapy. Sources of randomness and bias within the system were analyzed. Results: The relationship between CT imaging dose and patient treatment outcome was objectively quantified in terms of a singular value, the area under the TOC (AUTOC) curve. The AUTOC decreases more rapidly for low-dose imaging protocols. AUTOC variation introduced by the dose optimization algorithm was approximately 0.02%, at the 95% confidence interval. Conclusion: A model observer has been developed and implemented to assess image quality based on radiation therapy treatment efficacy. It enables objective determination of appropriate imaging parameter values (e.g. imaging dose). Framework flexibility allows for incorporation of additional modules to include any aspect of the treatment process, and therefore has great potential for both assessment and optimization within radiation therapy.

60 APPLIED LIFE SCIENCES↗

Region-of-interest diffuse optical tomography system

Diffuse optical tomography (DOT) using near-infrared light is a promising tool for non-invasive imaging of deep tissue. This technique is capable of quantitative reconstruction of absorption (μ{sub a}) and scattering coefficient (μ{sub s}) inhomogeneities in the tissue. The rationale for reconstructing the optical property map is that the absorption coefficient variation provides diagnostic information about metabolic and disease states of the tissue. The aim of DOT is to reconstruct the internal tissue cross section with good spatial resolution and contrast from noisy measurements non-invasively. We develop a region-of-interest scanning system based on DOT principles. Modulated light is injected into the phantom/tissue through one of the four light emitting diode sources. The light traversing through the tissue gets partially absorbed and scattered multiple times. The intensity and phase of the exiting light are measured using a set of photodetectors. The light transport through a tissue is diffusive in nature and is modeled using radiative transfer equation. However, a simplified model based on diffusion equation (DE) can be used if the system satisfies following conditions: (a) the optical parameter of the inhomogeneity is close to the optical property of the background, and (b) μ{sub s} of the medium is much greater than μ{sub a} (μ{sub s} > > μ{sub a}). The light transport through a highly scattering tissue satisfies both of these conditions. A discrete version of DE based on finite element method is used for solving the inverse problem. The depth of probing light inside the tissue depends on the wavelength of light, absorption, and scattering coefficients of the medium and the separation between the source and detector locations. Extensive simulation studies have been carried out and the results are validated using two sets of experimental measurements. The utility of the system can be further improved by using multiple wavelength light sources. In such a scheme, the spectroscopic variation of absorption coefficient in the tissue can be used to arrive at the oxygenation changes in the tissue.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

SU-E-I-33: Establishment of CT Diagnostic Reference Levels in Province Nova Scotia

Purpose: To evaluate patient radiation dose from the most frequently performed CT examinations and to establish provincial diagnostic reference levels (DRLs) as a tool for protocol optimization. Methods: The study investigated the following CT examinations: head, chest, abdomen/pelvis, and chest/abdomen/pelvis (CAP). Dose data, volume CT dose index (CTDIvol) and dose-length product (DLP), were collected from 15 CT scanners installed during 2004–2014 in 11 hospital sites of Nova Scotia. All scanners had dose modulation options and multislice capability (16–128 detector rows). The sample for each protocol included 15 average size patients (70±20 kg). Provincial DRLs were calculated as the 75th percentile of patient dose distributions. The differences in dose between hospitals were evaluated with a single factor ANOVA statistical test. Generalized linear modeling was used to determine the factors associated with higher radiation dose. A sample of 36 abdominal studies performed on three different scanners was blinded and randomized for an assessment by an experienced radiologist who graded the imaging quality of anatomic structures. Results: Data for 900 patients were collected. The DRLs were proposed using CTDIvol (mGy) and DLP (mGy*cm) values for CT head (67 and 1049, respectively), chest (12 and 393), abdomen/pelvis (16 and 717), and CAP (14 and 1034). These DRLs were lower than the published national data except for the head CTDIvol. The differences between the means of the dose distributions from each scanner were statistically significant (p<0.05) for all examinations. A very weak correlation was found between the dose and the scanner age or the number of slices with Pearson’s correlation coefficients of 0.011–0.315. The blinded analysis of image quality demonstrated no clinically significant difference except for the noise category. Conclusion: Provincial DRLs were established for typical CT examinations. The variations in dose between the hospitals suggested a large potential for optimization of examinations. Radiology Research Foundation grant.

60 APPLIED LIFE SCIENCES↗

TU-H-CAMPUS-IeP2-05: Breast and Soft Tissue-Equivalent 3D Printed Phantoms for Imaging and Dosimetry

Purpose: The study has the goal to demonstrate that breast and soft tissue-equivalent phantoms for dosimetry applications in the diagnostic energy range can be fabricated using common 3D printing methods. Methods: 3D printing provides the opportunity to rapidly prototype uniquely designed objects from a variety of materials. Common 3D printers are usually limited to printing objects based on thermoplastic materials such as PLA, or ABS. The most commonly available plastic is PLA, which has a density significantly greater than soft tissue. We utilized a popular 3D printer to demonstrate that tissue specific phantom materials can be generated through the careful selection of 3D printing parameters. A series of stepwedges were designed and printed using a Makerbot Replicator2 3D printing system. The print file provides custom adjustment of the infill density, orientation and position of the object on the printer stage, selection of infill patterns, and other control parameters. The x-ray attenuation and uniformity of fabricated phantoms were evaluated and compared to common tissue-equivalent phantom materials, acrylic and BR12. X-ray exposure measurements were made using narrow beam geometry on a clinical mammography unit at 28 kVp on the series of phantoms. The 3D printed phantoms were imaged at 28 kVp to visualize the internal structure and uniformity in different planes of the phantoms. Results: By utilizing specific in-fill density and patterns we are able to produce a phantom closely matching the attenuation characteristics of BR12 at 28 kVp. The in-fill patterns used are heterogeneous, so a judicious selection of fill pattern and the orientation of the fill pattern must be made in order to obtain homogenous attenuation along the intended direction of beam propagation. Conclusions: By careful manipulation of the printing parameters, breast and soft tissue-equivalent phantoms appropriate for use at imaging energies can be fabricated using 3D printing techniques.

60 APPLIED LIFE SCIENCES↗

SU-F-I-46: Optimizing Dose Reduction in Adult Head CT Protocols While Maintaining Image Quality in Postmortem Head Scans

Purpose: To optimize adult head CT protocol by reducing dose to an appropriate level while providing CT images of diagnostic quality. Methods: Five cadavers were scanned from the skull base to the vertex using a routine adult head CT protocol (120 kVp, 270 mA, 0.75 s rotation, 0.5 mm × 32 detectors, 70.8 mGy CTDIvol) followed by seven reduced-dose protocols with varying combinations of reduced tube current, reduced rotation time, and increased detectors with CTDIvol ranging from 38.2 to 65.6 mGy. Organ doses were directly measured with 21 OSL dosimeters placed on the surface and implanted in the head by a neurosurgeon. Two neuroradiologists assessed grey-white matter differentiation, fluid space, ventricular size, midline shift, brain mass, edema, ischemia, and skull fractures on a three point scale: (1) Unacceptable, (2) Borderline Acceptable, and (3) Acceptable. Results: For the standard scan, doses to the skin, lens of the eye, salivary glands, thyroid, and brain were 37.55 mGy, 49.65 mGy, 40.67 mGy, 4.63 mGy, and 27.33 mGy, respectively. Two cadavers had cerebral edema due to changing dynamics of postmortem effects, causing the grey-white matter differentiation to appear less distinct. Two cadavers with preserved grey-white matter received acceptable scores for all image quality features for the protocol with a CTDIvol of 57.3 mGy, allowing organ dose savings ranging from 34% to 45%. One cadaver allowed for greater dose reduction for the protocol with a CTDIvol of 42 mGy. Conclusion: Efforts to optimize scan protocol should consider both dose and clinical image quality. This is made possible with postmortem subjects, whose brains are similar to patients, allowing for an investigation of ideal scan parameters. Radiologists at our institution accepted scan protocols acquired with lower scan parameters, with CTDIvol values closer to the American College of Radiology’s (ACR) Achievable Dose level of 57 mGy.

60 APPLIED LIFE SCIENCES↗

TU-H-206-04: An Effective Homomorphic Unsharp Mask Filtering Method to Correct Intensity Inhomogeneity in Daily Treatment MR Images

Purpose: The daily treatment MRIs acquired on MR-IGRT systems, like diagnostic MRIs, suffer from intensity inhomogeneity issue, associated with B1 and B0 inhomogeneities. An improved homomorphic unsharp mask (HUM) filtering method, automatic and robust body segmentation, and imaging field-of-view (FOV) detection methods were developed to compute the multiplicative slow-varying correction field and correct the intensity inhomogeneity. The goal is to improve and normalize the voxel intensity so that the images could be processed more accurately by quantitative methods (e.g., segmentation and registration) that require consistent image voxel intensity values. Methods: HUM methods have been widely used for years. A body mask is required, otherwise the body surface in the corrected image would be incorrectly bright due to the sudden intensity transition at the body surface. In this study, we developed an improved HUM-based correction method that includes three main components: 1) Robust body segmentation on the normalized image gradient map, 2) Robust FOV detection (needed for body segmentation) using region growing and morphologic filters, and 3) An effective implementation of HUM using repeated Gaussian convolution. Results: The proposed method was successfully tested on patient images of common anatomical sites (H/N, lung, abdomen and pelvis). Initial qualitative comparisons showed that this improved HUM method outperformed three recently published algorithms (FCM, LEMS, MICO) in both computation speed (by 50+ times) and robustness (in intermediate to severe inhomogeneity situations). Currently implemented in MATLAB, it takes 20 to 25 seconds to process a 3D MRI volume. Conclusion: Compared to more sophisticated MRI inhomogeneity correction algorithms, the improved HUM method is simple and effective. The inhomogeneity correction, body mask, and FOV detection methods developed in this study would be useful as preprocessing tools for many MRI-related research and clinical applications in radiotherapy. Authors have received research grants from ViewRay and Varian.

60 APPLIED LIFE SCIENCES↗

TH-CD-201-01: BEST IN PHYSICS (THERAPY): Assessment of Thin-Film CdTe as An Effective Detector for Microdosimety at Gold-Tissue Interface

Purpose: Presence of interfaces between high and low atomic number materials, often encountered in diagnostic imaging and radiation therapy, leads to radiation dose perturbation. This phenomenon is characterized by a very narrow region of sharp dose enhancement at the interface. The rapid fall-off of the dose enhancement over a very short distance from the interface makes the experimental dosimetry nontrivial. We use an in-house-built inexpensive thin-film Cadmium Telluride (CdTe) photodetector to study this effect at the gold-tissue interface and verify our experimental results with Monte Carlo (MC) modeling. Methods: Three micron thick CdTe photodetectors were fabricated in our lab. One, ten or one hundred micron thick gold foils placed in a tissue-equivalent-phantom were irradiated with a clinical Ir-192 high dose rate source and current measured with a CdTe detector in each case was compared against the current measured for all uniform tissue-equivalent phantom. Percentage signal enhancement (PSE) due to each gold foil was compared against MC modeled percentage dose enhancement (PDE), obtained from the geometry mimicking the experimental setup. Results: The experiment based PSEs due to 1, 10, and 100 micron thick gold foils at the closest measured distance of measurement (12.5 micron) from the interface were 42.6 ± 10.8, 137.0 ± 11.9 and 203.0 ± 15.4 respectively. The corresponding MC modeled PDEs were 38.1 ± 1, 164 ± 1 and 249 ± 1 respectively. The experimental and MC modeled values showed a closer agreement at the larger distances from the interface. Conclusion: The dose enhancement near the gold-tissue interface was measured using an in-house-built high-resolution CdTe-based photodetector and validated with MC simulations. A close agreement of the experimental results with the corresponding MC modeled results shows that CdTe detector can be utilized for mapping interface dose distribution encountered in the application of ionizing radiation.

60 APPLIED LIFE SCIENCES↗

Laser Wakefield Acceleration: Structural and Dynamic Studies. Final Technical Report ER40954

Particle accelerators enable scientists to study the fundamental structure of the universe, but have become the largest and most expensive of scientific instruments. In this project, we advanced the science and technology of laser-plasma accelerators, which are thousands of times smaller and less expensive than their conventional counterparts. In a laser-plasma accelerator, a powerful laser pulse exerts light pressure on an ionized gas, or plasma, thereby driving an electron density wave, which resembles the wake behind a boat. Electrostatic fields within this plasma wake reach tens of billions of volts per meter, fields far stronger than ordinary non-plasma matter (such as the matter that a conventional accelerator is made of) can withstand. Under the right conditions, stray electrons from the surrounding plasma become trapped within these “wake-fields”, surf them, and acquire energy much faster than is possible in a conventional accelerator. Laser-plasma accelerators thus might herald a new generation of compact, low-cost accelerators for future particle physics, x-ray and medical research. In this project, we made two major advances in the science of laser-plasma accelerators. The first of these was to accelerate electrons beyond 1 gigaelectronvolt (1 GeV) for the first time. In experimental results reported in Nature Communications in 2013, about 1 billion electrons were captured from a tenuous plasma (about 1/100 of atmosphere density) and accelerated to 2 GeV within about one inch, while maintaining less than 5% energy spread, and spreading out less than ½ milliradian (i.e. ½ millimeter per meter of travel). Low energy spread and high beam collimation are important for applications of accelerators as coherent x-ray sources or particle colliders. This advance was made possible by exploiting unique properties of the Texas Petawatt Laser, a powerful laser at the University of Texas at Austin that produces pulses of 150 femtoseconds (1 femtosecond is 10-15 seconds) in duration and 150 Joules in energy (equivalent to the muzzle energy of a small pistol bullet). This duration was well matched to the natural electron density oscillation period of plasma of 1/100 atmospheric density, enabling efficient excitation of a plasma wake, while this energy was sufficient to drive a high-amplitude wake of the right shape to produce an energetic, collimated electron beam. Continuing research is aimed at increasing electron energy even further, increasing the number of electrons captured and accelerated, and developing applications of the compact, multi-GeV accelerator as a coherent, hard x-ray source for materials science, biomedical imaging and homeland security applications. The second major advance under this project was to develop new methods of visualizing the laser-driven plasma wake structures that underlie laser-plasma accelerators. Visualizing these structures is essential to understanding, optimizing and scaling laser-plasma accelerators. Yet prior to work under this project, computer simulations based on estimated initial conditions were the sole source of detailed knowledge of the complex, evolving internal structure of laser-driven plasma wakes. In this project we developed and demonstrated a suite of optical visualization methods based on well-known methods such as holography, streak cameras, and coherence tomography, but adapted to the ultrafast, light-speed, microscopic world of laser-driven plasma wakes. Our methods output images of laser-driven plasma structures in a single laser shot. We first reported snapshots of low-amplitude laser wakes in Nature Physics in 2006. We subsequently reported images of high-amplitude laser-driven plasma “bubbles”, which are important for producing electron beams with low energy spread, in Physical Review Letters in 2010. More recently, we have figured out how to image laser-driven structures that change shape while propagating in a single laser shot. The latter techniques, which use the methods of computerized tomography, were demonstrated on test objects – e.g. laser-driven filaments in air and glass – and reported in Optics Letters in 2013 and Nature Communications in 2014. Their output is a multi-frame movie rather than a snapshot. Continuing research is aimed at applying these tomographic methods directly to evolving laser-driven plasma accelerator structures in our laboratory, then, once perfected, to exporting them to plasma-based accelerator laboratories around the world as standard in-line metrology instruments.

43 PARTICLE ACCELERATORS↗