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At least 451 records · Page 25
All sourcesNASA NTRSDOE OSTI
DOE OSTI2013

Comparison of the Effects of High-Energy Photon Beam Irradiation (10 and 18 MV) on 2 Types of Implantable Cardioverter-Defibrillators

Purpose: Radiation therapy for cancer may be required for patients with implantable cardiac devices. However, the influence of secondary neutrons or scattered irradiation from high-energy photons (≥10 MV) on implantable cardioverter-defibrillators (ICDs) is unclear. This study was performed to examine this issue in 2 ICD models. Methods and Materials: ICDs were positioned around a water phantom under conditions simulating clinical radiation therapy. The ICDs were not irradiated directly. A control ICD was positioned 140 cm from the irradiation isocenter. Fractional irradiation was performed with 18-MV and 10-MV photon beams to give cumulative in-field doses of 600 Gy and 1600 Gy, respectively. Errors were checked after each fraction. Soft errors were defined as severe (change to safety back-up mode), moderate (memory interference, no changes in device parameters), and minor (slight memory change, undetectable by computer). Results: Hard errors were not observed. For the older ICD model, the incidences of severe, moderate, and minor soft errors at 18 MV were 0.75, 0.5, and 0.83/50 Gy at the isocenter. The corresponding data for 10 MV were 0.094, 0.063, and 0 /50 Gy. For the newer ICD model at 18 MV, these data were 0.083, 2.3, and 5.8 /50 Gy. Moderate and minor errors occurred at 18 MV in control ICDs placed 140 cm from the isocenter. The error incidences were 0, 1, and 0 /600 Gy at the isocenter for the newer model, and 0, 1, and 6 /600Gy for the older model. At 10 MV, no errors occurred in control ICDs. Conclusions: ICD errors occurred more frequently at 18 MV irradiation, which suggests that the errors were mainly caused by secondary neutrons. Soft errors of ICDs were observed with high energy photon beams, but most were not critical in the newer model. These errors may occur even when the device is far from the irradiation field.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Modeling Local Control After Hypofractionated Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer: A Report From the Elekta Collaborative Lung Research Group

Purpose: Hypofractionated stereotactic body radiation therapy (SBRT) has emerged as an effective treatment option for early-stage non-small cell lung cancer (NSCLC). Using data collected by the Elekta Lung Research Group, we generated a tumor control probability (TCP) model that predicts 2-year local control after SBRT as a function of biologically effective dose (BED) and tumor size. Methods and Materials: We formulated our TCP model as follows: TCP = e{sup [BED10-c Asterisk-Operator L-TCD50]/k} Division-Sign (1 + e{sup [BED10-c Asterisk-Operator L-TCD50]/k}), where BED10 is the biologically effective SBRT dose, c is a constant, L is the maximal tumor diameter, and TCD50 and k are parameters that define the shape of the TCP curve. Least-squares optimization with a bootstrap resampling approach was used to identify the values of c, TCD50, and k that provided the best fit with observed actuarial 2-year local control rates. Results: Data from 504 NSCLC tumors treated with a variety of SBRT schedules were available. The mean follow-up time was 18.4 months, and 26 local recurrences were observed. The optimal values for c, TCD50, and k were 10 Gy/cm, 0 Gy, and 31 Gy, respectively. Thus, size-adjusted BED (sBED) may be defined as BED minus 10 times the tumor diameter (in centimeters). Our TCP model indicates that sBED values of 44 Gy, 69 Gy, and 93 Gy provide 80%, 90%, and 95% chances of tumor control at 2 years, respectively. When patients were grouped by sBED, the model accurately characterized the relationship between sBED and actuarial 2-year local control (r=0.847, P=.008). Conclusion: We have developed a TCP model that predicts 2-year local control rate after hypofractionated SBRT for early-stage NSCLC as a function of biologically effective dose and tumor diameter. Further testing of this model with additional datasets is warranted.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Implementation of a Novel Algorithm For Generating Synthetic CT Images From Magnetic Resonance Imaging Data Sets for Prostate Cancer Radiation Therapy

Purpose: To describe and evaluate a method for generating synthetic computed tomography (synCT) images from magnetic resonance simulation (MR-SIM) data for accurate digitally reconstructed radiograph (DRR) generation and dose calculations in prostate cancer radiation therapy. Methods and Materials: A retrospective evaluation was performed in 9 prostate cancer patients who had undergone MR-SIM in addition to CT simulation (CT-SIM). MR-SIM data were used to generate synCT images by using a novel, voxel-based weighted summation approach. A subset of patients was used for weight optimization, and the number of patients to use during optimization was determined. Hounsfield unit (HU) differences between CT-SIM and synCT images were analyzed via mean absolute error (MAE). Original, CT-based treatment plans were mapped onto synCTs. DRRs were generated, and agreement between CT and synCT-generated DRRs was evaluated via Dice similarity coefficient (DSC). Dose was recalculated, and dose-volume metrics and gamma analysis were used to evaluate resulting treatment plans. Results: Full field-of-view synCT MAE across all patients was 74.3 ± 10.9 HU with differences from CTs of 2.0 ± 8.1 HU and 11.9 ± 46.7 HU for soft tissue structures (prostate, bladder, and rectum) and femoral bones, respectively. Calculated DSCs for anterior-posterior and lateral DRRs were 0.90 ± 0.04 and 0.92 ± 0.05, respectively. Differences in D99%, mean dose, and maximum dose to the clinical target volume from CT-SIM dose calculations were 0.75% ± 0.35%, 0.63% ± 0.34%, and 0.54% ± 0.33%, respectively, for synCT-generated plans. Gamma analysis (2%/2 mm dose difference/distance to agreement) revealed pass rates of 99.9% ± 0.1% (range, 99.7%-100%). Conclusion: Generated synCTs enabled accurate DRR generation and dose computation for prostate MR-only simulation. Dose recalculated on synCTs agreed well with original planning distributions. Further validation using a larger patient cohort is warranted.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Toward IMRT 2D dose modeling using artificial neural networks: A feasibility study

Purpose: To investigate the feasibility of artificial neural networks (ANN) to reconstruct dose maps for intensity modulated radiation treatment (IMRT) fields compared with those of the treatment planning system (TPS). Methods: An artificial feed forward neural network and the back-propagation learning algorithm have been used to replicate dose calculations of IMRT fields obtained from PINNACLE{sup 3} v9.0. The ANN was trained with fluence and dose maps of IMRT fields for 6 MV x-rays, which were obtained from the amorphous silicon (a-Si) electronic portal imaging device of Novalis TX. Those fluence distributions were imported to the TPS and the dose maps were calculated on the horizontal midpoint plane of a water equivalent homogeneous cylindrical virtual phantom. Each exported 2D dose distribution from the TPS was classified into two clusters of high and low dose regions, respectively, based on the K-means algorithm and the Euclidian metric in the fluence-dose domain. The data of each cluster were divided into two sets for the training and validation phase of the ANN, respectively. After the completion of the ANN training phase, 2D dose maps were reconstructed by the ANN and isodose distributions were created. The dose maps reconstructed by ANN were evaluated and compared with the TPS, where the mean absolute deviation of the dose and the {gamma}-index were used. Results: A good agreement between the doses calculated from the TPS and the trained ANN was achieved. In particular, an average relative dosimetric difference of 4.6% and an average {gamma}-index passing rate of 93% were obtained for low dose regions, and a dosimetric difference of 2.3% and an average {gamma}-index passing rate of 97% for high dose region. Conclusions: An artificial neural network has been developed to convert fluence maps to corresponding dose maps. The feasibility and potential of an artificial neural network to replicate complex convolution kernels in the TPS for IMRT dose calculations have been demonstrated.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

Simple shielding reduces dose to the contralateral breast during prone breast cancer radiotherapy

Our goal was to design a prone breast shield for the contralateral breast and study its efficacy in decreasing scatter radiation to the contralateral breast in a prone breast phantom setup receiving radiation therapy designed for breast cancer. We constructed a prone breast phantom setup consisting of (1) A thermoplastic mask with a left-sided depression created by a water balloon for a breast shape; (2) 2 plastic bags to hold water in the thermoplastic mask depression; (3) 2000 mL of water to fill the thermoplastic mask depression to create a water-based false breast; (4) 1-cm thick bolus placed in the contralateral breast holder; (5) 2 lead (Pb) sheets, each 0.1-cm thick for blocking scatter radiation in the contralateral bolus-based false breast; (6) a prone breast board to hold the thermoplastic mask, water, bolus, and lead; (7) 9 cm solid water on top of the breast board to simulate body; (8) a diode was used to verify dose for each treatment field of the treated water-based breast; (9) metal–oxide–semiconductor-field effect transistor (MOSFET) dosimeters to measure dose to the contralateral bolus-based breast. The phantom prone breast setup was CT simulated and treatment was designed with 95% isodose line covering the treated breast. The maximum dose was 107.1%. Megavoltage (MV) port images ensured accurate setup. Measurements were done using diodes on the treated water-based breast and MOSFET dosimeters at the medial and lateral sides of the contralateral bolus-based breast without and with the Pb shield. Five treatments were done for each of the 3 data sets and recorded individually for statistical purposes. All treatments were completed with 6 MV photons at 200 cGy per treatment. The dose contributions from each of the 3 data sets including 15 treatments total without and with the prone lead shield to the medial and lateral portions of contralateral bolus-based breast were averaged individually. Unshielded dose means were 37.11 and 2.94 cGy, and shielded dose means were 12.68 and 1.54 cGy, respectively. When comparing medial and lateral portions of the contralateral bolus-based doses without and with Pb, the shield significantly reduced dose to both sides of the contralateral breast (medial p = 2.64 × 10{sup −14}, lateral p = 4.91 × 10{sup −6}). The prone 0.2-cm Pb shield significantly reduced scatter dose to the contralateral breast on the order of 2 to 3 times. Reductions may be clinically relevant for women younger than 45 years by decreasing the risk of contralateral radiation-induced breast cancer in patients receiving radiation therapy for breast cancer. This shield is simple as it would be a part of the prone breast board during treatments, but future studies are warranted for safety and efficacy clinically.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

Assessing the Dosimetric Accuracy of Magnetic Resonance-Generated Synthetic CT Images for Focal Brain VMAT Radiation Therapy

Purpose: The purpose of this study was to assess the dosimetric accuracy of synthetic CT (MRCT) volumes generated from magnetic resonance imaging (MRI) data for focal brain radiation therapy. Methods and Materials: A study was conducted in 12 patients with gliomas who underwent both MR and CT imaging as part of their simulation for external beam treatment planning. MRCT volumes were generated from MR images. Patients' clinical treatment planning directives were used to create 12 individual volumetric modulated arc therapy (VMAT) plans, which were then optimized 10 times on each of their respective CT and MRCT-derived electron density maps. Dose metrics derived from optimization criteria, as well as monitor units and gamma analyses, were evaluated to quantify differences between the imaging modalities. Results: Mean differences between planning target volume (PTV) doses on MRCT and CT plans across all patients were 0.0% (range: −0.1 to 0.2%) for D{sub 95%}; 0.0% (−0.7 to 0.6%) for D{sub 5%}; and −0.2% (−1.0 to 0.2%) for D{sub max}. MRCT plans showed no significant changes in monitor units (−0.4%) compared to CT plans. Organs at risk (OARs) had average D{sub max} differences of 0.0 Gy (−2.2 to 1.9 Gy) over 85 structures across all 12 patients, with no significant differences when calculated doses approached planning constraints. Conclusions: Focal brain VMAT plans optimized on MRCT images show excellent dosimetric agreement with standard CT-optimized plans. PTVs show equivalent coverage, and OARs do not show any overdose. These results indicate that MRI-derived synthetic CT volumes can be used to support treatment planning of most patients treated for intracranial lesions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Dose reduction using a dynamic, piecewise-linear attenuator

Purpose: The authors recently proposed a dynamic, prepatient x-ray attenuator capable of producing a piecewise-linear attenuation profile customized to each patient and viewing angle. This attenuator was intended to reduce scatter-to-primary ratio (SPR), dynamic range, and dose by redistributing flux. In this work the authors tested the ability of the attenuator to reduce dose and SPR in simulations. Methods: The authors selected four clinical applications, including routine full field-of-view scans of the thorax and abdomen, and targeted reconstruction tasks for an abdominal aortic aneurysm and the pancreas. Raw data were estimated by forward projection of the image volume datasets. The dynamic attenuator was controlled to reduce dose while maintaining peak variance by solving a convex optimization problem, assuminga priori knowledge of the patient anatomy. In targeted reconstruction tasks, the noise in specific regions was given increased weighting. A system with a standard attenuator (or “bowtie filter”) was used as a reference, and used either convex optimized tube current modulation (TCM) or a standard TCM heuristic. The noise of the scan was determined analytically while the dose was estimated using Monte Carlo simulations. Scatter was also estimated using Monte Carlo simulations. The sensitivity of the dynamic attenuator to patient centering was also examined by shifting the abdomen in 2 cm intervals. Results: Compared to a reference system with optimized TCM, use of the dynamic attenuator reduced dose by about 30% in routine scans and 50% in targeted scans. Compared to the TCM heuristics which are typically used withouta priori knowledge, the dose reduction is about 50% for routine scans. The dynamic attenuator gives the ability to redistribute noise and variance and produces more uniform noise profiles than systems with a conventional bowtie filter. The SPR was also modestly reduced by 10% in the thorax and 24% in the abdomen. Imaging with the dynamic attenuator was relatively insensitive to patient centering, showing a 17% increase in peak variance for a 6 cm shift of the abdomen, instead of an 82% increase in peak variance for a fixed bowtie filter. Conclusions: A dynamic prepatient x-ray attenuator consisting of multiple wedges is capable of achieving substantial dose reductions and modest SPR reductions.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Investigation of realistic PET simulations incorporating tumor patient's specificity using anthropomorphic models: Creation of an oncology database

Purpose: The GATE Monte Carlo simulation toolkit is used for the implementation of realistic PET simulations incorporating tumor heterogeneous activity distributions. The reconstructed patient images include noise from the acquisition process, imaging system's performance restrictions and have limited spatial resolution. For those reasons, the measured intensity cannot be simply introduced in GATE simulations, to reproduce clinical data. Investigation of the heterogeneity distribution within tumors applying partial volume correction (PVC) algorithms was assessed. The purpose of the present study was to create a simulated oncology database based on clinical data with realistic intratumor uptake heterogeneity properties.Methods: PET/CT data of seven oncology patients were used in order to create a realistic tumor database investigating the heterogeneity activity distribution of the simulated tumors. The anthropomorphic models (NURBS based cardiac torso and Zubal phantoms) were adapted to the CT data of each patient, and the activity distribution was extracted from the respective PET data. The patient-specific models were simulated with the Monte Carlo Geant4 application for tomography emission (GATE) in three different levels for each case: (a) using homogeneous activity within the tumor, (b) using heterogeneous activity distribution in every voxel within the tumor as it was extracted from the PET image, and (c) using heterogeneous activity distribution corresponding to the clinical image following PVC. The three different types of simulated data in each case were reconstructed with two iterations and filtered with a 3D Gaussian postfilter, in order to simulate the intratumor heterogeneous uptake. Heterogeneity in all generated images was quantified using textural feature derived parameters in 3D according to the ground truth of the simulation, and compared to clinical measurements. Finally, profiles were plotted in central slices of the tumors, across lines with heterogeneous activity distribution for visual assessment.Results: The accuracy of the simulated database was assessed against the original clinical images. The PVC simulated images matched the clinical ones best. Local, regional, and global features extracted from the PVC simulated images were closest to the clinical measurements, with the exception of the size zone variability and the mean intensity values, where heterogeneous tumors showed better reproducibility. The profiles on PVC simulated tumors after postfiltering seemed to represent the more realistic heterogeneous regions with respect to the clinical reference.Conclusions: In this study, the authors investigated the input activity map heterogeneity in the GATE simulations of tumors with heterogeneous activity distribution. The most realistic heterogeneous tumors were obtained by inserting PVC activity distributions from the clinical image into the activity map of the simulation. Partial volume effect (PVE) can play a crucial role in the quantification of heterogeneity within tumors and have an important impact on applications such as patient follow-up during treatment and assessment of tumor response to therapy. The development of such a database incorporating patient anatomical and functional variability can be used to evaluate new image processing or analysis algorithms, while providing control of the ground truth, which is not available when dealing with clinical datasets. The database includes all images used and generated in this study, as well as the sinograms and the attenuation phantoms for further investigation. It is freely available to the interested reader of the journal at http://www.med.upatras.gr/oncobase/.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Controlling Intake of Uranium in the Workplace: Applications of Biokinetic Modeling and Occupational Monitoring Data

This report provides methods for interpreting and applying occupational uranium monitoring data. The methods are based on current international radiation protection guidance, current information on the chemical toxicity of uranium, and best available biokinetic models for uranium. Emphasis is on air monitoring data and three types of bioassay data: the concentration of uranium in urine; the concentration of uranium in feces; and the externally measured content of uranium in the chest. Primary Reference guidance levels for prevention of chemical effects and limitation of radiation effects are selected based on a review of current scientific data and regulatory principles for setting standards. Generic investigation levels and immediate action levels are then defined in terms of these primary guidance levels. The generic investigation and immediate actions levels are stated in terms of radiation dose and concentration of uranium in the kidneys. These are not directly measurable quantities, but models can be used to relate the generic levels to the concentration of uranium in air, urine, or feces, or the total uranium activity in the chest. Default investigation and immediate action levels for uranium in air, urine, feces, and chest are recommended for situations in which there is little information on the form of uranium taken into the body. Methods are prescribed also for deriving case-specific investigation and immediate action levels for uranium in air, urine, feces, and chest when there is sufficient information on the form of uranium to narrow the range of predictions of accumulation of uranium in the main target organs for uranium: kidneys for chemical effects and lungs for radiological effects. In addition, methods for using the information herein for alternative guidance levels, different from the ones selected for this report, are described.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2014

EM reconstruction of dual isotope PET using staggered injections and prompt gamma positron emitters

Purpose: The aim of dual isotope positron emission tomography (DIPET) is to create two separate images of two coinjected PET radiotracers. DIPET shortens the duration of the study, reduces patient discomfort, and produces perfectly coregistered images compared to the case when two radiotracers would be imaged independently (sequential PET studies). Reconstruction of data from such simultaneous acquisition of two PET radiotracers is difficult because positron decay of any isotope creates only 511 keV photons; therefore, the isotopes cannot be differentiated based on the detected energy. Methods: Recently, the authors have proposed a DIPET technique that uses a combination of radiotracer A which is a pure positron emitter (such as{sup 18}F or {sup 11}C) and radiotracer B in which positron decay is accompanied by the emission of a high-energy (HE) prompt gamma (such as {sup 38}K or {sup 60}Cu). Events that are detected as triple coincidences of HE gammas with the corresponding two 511 keV photons allow the authors to identify the lines-of-response (LORs) of isotope B. These LORs are used to separate the two intertwined distributions, using a dedicated image reconstruction algorithm. In this work the authors propose a new version of the DIPET EM-based reconstruction algorithm that allows the authors to include an additional, independent estimate of radiotracer A distribution which may be obtained if radioisotopes are administered using a staggered injections method. In this work the method is tested on simple simulations of static PET acquisitions. Results: The authors’ experiments performed using Monte-Carlo simulations with static acquisitions demonstrate that the combined method provides better results (crosstalk errors decrease by up to 50%) than the positron-gamma DIPET method or staggered injections alone. Conclusions: The authors demonstrate that the authors’ new EM algorithm which combines information from triple coincidences with prompt gammas and staggered injections improves the accuracy of DIPET reconstructions for static acquisitions so they reach almost the benchmark level calculated for perfectly separated tracers.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2020

Choosing the Best Modeling Platform for Radiological Risk Assessment Models - 20468

Radiological risk assessments, in the form of performance or safety assessments, are often required under regulations or guidance for remediation of contaminated land, decommissioning of contaminated buildings or structures, and radioactive waste disposal. These risk assessments are usually supported by fate and transport models that address decay and ingrowth of radionuclides, as well as their movement through engineered systems and the natural environment. These models are often projected thousands, or more, years into the future, largely because the radioactive species change through decay and ingrowth, and hence the magnitude of the radioactive effect changes with time. There are many computer codes that are available to address this type of modeling. They range from addressing specific pathways or processes such as infiltration of water, groundwater, surface water, air, biota, diffusion and advection of water and gases, to those that try to couple all processes together to evaluate the impact of fate and transport through the entire system to places in space and time to which access is assumed. These different types of codes are sometimes separated with the monikers process-level and systems-level codes, although it is often not clear that this separation does justice to the capabilities of the many codes that are available to evaluate fate and transport of radionuclides. The focus of this paper is the latter group of modeling codes. Several systems level modeling codes exist and are used. There are differences between these codes in terms of utility, flexibility, complexity and cost. The purpose of this paper is to compare a few of these codes in the context of work currently being performed by the International Atomic Energy Agency (IAEA) Modeling and Data for Radiological Impact Assessments (MODARIA) II Working Group 1 (WG1). The MODARIA II WG1's main focus is how stakeholder engaged decision analysis can, or should, be applied to radiological contamination problems so that better, longstanding, sustainable, solutions are reached. However, the WG1 also recognizes the potential impact of the modeling tools that are chosen to address radiological risk, which is often a primary objective of decision making for radiological problems. Other objectives might also be important, such as constraining costs, obtaining financing, minimizing impact on ecosystems, saving cultural resources, saving jobs, farmland, environmental justice, etc., in a full decision analysis for a given radiological contamination problem, but none of these other objectives have the same types of complex modeling needs as minimize radiological dose. Consequently, a further focus of WG1 is to evaluate the potential impacts on decision making of the choice of fate and transport, and risk assessment, modeling codes that are used to support decision making. The WG1 will produce a report at the end of 2020 that will focus on an approach to effective decision making and stakeholder engagement. The report will also consider the role that performance assessment modeling should play in the decision-making process, including the impact of the choice of modeling tools or computer codes on risk-informed decision making. Several sites around the World have been made available by Member States for these model comparisons, and several modeling tools have been considered. However, the focus of this paper is on two of the sites, one in Belgium and one in Ukraine, and on three of the tools: NORMALYSA (NORM And Legacy Site Assessment); GoldSim{sup C}, and AMBER{sup C}. The final report from this working group will also cover other modeling tools, including RESRAD, and PC-Cream{sup R}. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2012

Temporal and spectral imaging with micro-CT

Purpose: Micro-CT is widely used for small animal imaging in preclinical studies of cardiopulmonary disease, but further development is needed to improve spatial resolution, temporal resolution, and material contrast. We present a technique for visualizing the changing distribution of iodine in the cardiac cycle with dual source micro-CT. Methods: The approach entails a retrospectively gated dual energy scan with optimized filters and voltages, and a series of computational operations to reconstruct the data. Projection interpolation and five-dimensional bilateral filtration (three spatial dimensions + time + energy) are used to reduce noise and artifacts associated with retrospective gating. We reconstruct separate volumes corresponding to different cardiac phases and apply a linear transformation to decompose these volumes into components representing concentrations of water and iodine. Since the resulting material images are still compromised by noise, we improve their quality in an iterative process that minimizes the discrepancy between the original acquired projections and the projections predicted by the reconstructed volumes. The values in the voxels of each of the reconstructed volumes represent the coefficients of linear combinations of basis functions over time and energy. We have implemented the reconstruction algorithm on a graphics processing unit (GPU) with CUDA. We tested the utility of the technique in simulations and applied the technique in an in vivo scan of a C57BL/6 mouse injected with blood pool contrast agent at a dose of 0.01 ml/g body weight. Postreconstruction, at each cardiac phase in the iodine images, we segmented the left ventricle and computed its volume. Using the maximum and minimum volumes in the left ventricle, we calculated the stroke volume, the ejection fraction, and the cardiac output. Results: Our proposed method produces five-dimensional volumetric images that distinguish different materials at different points in time, and can be used to segment regions containing iodinated blood and compute measures of cardiac function. Conclusions: We believe this combined spectral and temporal imaging technique will be useful for future studies of cardiopulmonary disease in small animals.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Dosimetric perturbations due to an implanted cardiac pacemaker in MammoSite{sup Registered-Sign} treatment

Purpose: To investigate dose perturbations for pacemaker-implanted patients in partial breast irradiation using high dose rate (HDR) balloon brachytherapy. Methods: Monte Carlo (MC) simulations were performed to calculate dose distributions involving a pacemaker in Ir-192 HDR balloon brachytherapy. Dose perturbations by varying balloon-to-pacemaker distances (BPD = 50 or 100 mm) and concentrations of iodine contrast medium (2.5%, 5.0%, 7.5%, and 10.0% by volume) in the balloon were investigated for separate parts of the pacemaker (i.e., battery and substrate). Relative measurements using an ion-chamber were also performed to confirm MC results. Results: The MC and measured results in homogeneous media without a pacemaker agreed with published data within 2% from the balloon surface to 100 mm BPD. Further their dose distributions with a pacemaker were in a comparable agreement. The MC results showed that doses over the battery were increased by a factor of 3, compared to doses without a pacemaker. However, there was no significant dose perturbation in the middle of substrate but up to 70% dose increase in the substrate interface with the titanium capsule. The attenuation by iodine contrast medium lessened doses delivered to the pacemaker by up to 9%. Conclusions: Due to inhomogeneity of pacemaker and contrast medium as well as low-energy photons in Ir-192 HDR balloon brachytherapy, the actual dose received in a pacemaker is different from the homogeneous medium-based dose and the external beam-based dose. Therefore, the dose perturbations should be considered for pacemaker-implanted patients when evaluating a safe clinical distance between the balloon and pacemaker.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2012

Quantitative Assessment of Workload and Stressors in Clinical Radiation Oncology

Purpose: Workload level and sources of stressors have been implicated as sources of error in multiple settings. We assessed workload levels and sources of stressors among radiation oncology professionals. Furthermore, we explored the potential association between workload and the frequency of reported radiotherapy incidents by the World Health Organization (WHO). Methods and Materials: Data collection was aimed at various tasks performed by 21 study participants from different radiation oncology professional subgroups (simulation therapists, radiation therapists, physicists, dosimetrists, and physicians). Workload was assessed using National Aeronautics and Space Administration Task-Load Index (NASA TLX). Sources of stressors were quantified using observational methods and segregated using a standard taxonomy. Comparisons between professional subgroups and tasks were made using analysis of variance ANOVA, multivariate ANOVA, and Duncan test. An association between workload levels (NASA TLX) and the frequency of radiotherapy incidents (WHO incidents) was explored (Pearson correlation test). Results: A total of 173 workload assessments were obtained. Overall, simulation therapists had relatively low workloads (NASA TLX range, 30-36), and physicists had relatively high workloads (NASA TLX range, 51-63). NASA TLX scores for physicians, radiation therapists, and dosimetrists ranged from 40-52. There was marked intertask/professional subgroup variation (P<.0001). Mental demand (P<.001), physical demand (P=.001), and effort (P=.006) significantly differed among professional subgroups. Typically, there were 3-5 stressors per cycle of analyzed tasks with the following distribution: interruptions (41.4%), time factors (17%), technical factors (13.6%), teamwork issues (11.6%), patient factors (9.0%), and environmental factors (7.4%). A positive association between workload and frequency of reported radiotherapy incidents by the WHO was found (r = 0.87, P value=.045). Conclusions: Workload level and sources of stressors vary among professional subgroups. Understanding the factors that influence these findings can guide adjustments to the workflow procedures, physical layout, and/or communication protocols to enhance safety. Additional evaluations are needed in order to better understand if these findings are systemic.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Four-Dimensional Dose Reconstruction for Scanned Proton Therapy Using Liver 4DCT-MRI

Purpose: Four-dimensional computed tomography-magnetic resonance imaging (4DCT-MRI) is an image-processing technique for simulating many 4DCT data sets from a static reference CT and motions extracted from 4DMRI studies performed using either volunteers or patients. In this work, different motion extraction approaches were tested using 6 liver cases, and a detailed comparison between 4DCT-MRI and 4DCT was performed. Methods and Materials: 4DCT-MRI has been generated using 2 approaches. The first approach used motion extracted from 4DMRI as being “most similar” to that of 4DCT from the same patient (subject-specific), and the second approach used the most similar motion obtained from a motion library derived from 4DMRI liver studies of 13 healthy volunteers (population-based). The resulting 4DCT-MRI and 4DCTs were compared using scanned proton 4D dose calculations (4DDC). Results: Dosimetric analysis showed that 93% ± 8% of points inside the clinical target volume (CTV) agreed between 4DCT and subject-specific 4DCT-MRI (gamma analysis: 3%/3 mm). The population-based approach however showed lower dosimetric agreement with only 79% ± 14% points in the CTV reaching the 3%/3 mm criteria. Conclusions: 4D CT-MRI extends the capabilities of motion modeling for dose calculations by accounting for realistic and variable motion patterns, which can be directly employed in clinical research studies. We have found that the subject-specific liver modeling appears more accurate than the population-based approach. The former is particularly interesting for clinical applications, such as improved target delineation and 4D dose reconstruction for patient-specific QA to allow for inter- and/or intra-fractional plan corrections.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

A Grid Intensity Map-Based Source Model for Monte Carlo Modeling of IMRT Field Irradiation - Paper 5

An accurate source model is important for TPS (Treatment Planning System) dose calculation and verification, especially for IMRT (Intensity Modulated Radiotherapy) irregular and inhomogeneous fields. Monte Carlo simulation is the most accurate way to calculate dose distributions in the heterogeneous media like human bodies. A full radiotherapy modeling generally includes Linac modeling and phantom dose calculation. Full Linac modeling is very time-consuming and requires highly detailed knowledge of the accelerator composition and structure, however, which is very difficult to obtain for commercial interests. Often all relevant parameters are not known with sufficient accuracy, and thus a time-consuming tuning of e.g. the electron beam spot size and energy must be performed. A multiple source model (MSM) regards particles coming from different parts of an accelerator as if they are coming from different virtual sources. MSM uses a set of virtual sources representing the treatment beam (e.g. primary photons, head scatter, electron contamination) by a set of analytic functions or histograms with parameters derived from dosimetric measurements or a full MC simulation. Tillikainen et al built a three sub-source model by matching with measurement data using an automatic process to optimize the free model parameters for a Varian 2100 C/D accelerator. Lin et al have built a convenient five-photon-sub-source model for Varian 2300C 6 MV-X beam based on Monte Carlo simulated Linac for ARTS (Accurate Radiotherapy System). The particle generation of MSM is very fast compared to full Linac simulation, and its sampling efficiency is not limited by the size of the phase space file (PSF). However, generally MSM is generated based on regular field PSF and needs an irregular component to form the beam shape meanwhile apt to bringing error Linac modeling and MSM producing from PSF analysis actually both are multi-freedom optimization process by adjusting several parameters (e.g. electron energy and angular divergence). Linac modeling adjusts its parameters from the beginning of electron hitting target through all components to fit the simulation to the measurement. MSM tunes its PSF-derived parameters by optimizing to minimize the deviations between the simulation and the measurement. Since the full Linac modeling and the MSM model both need to fine tune their parameters to match the simulation to the measurement, and sometimes maybe offsets the real accelerator for its multi-parameter optimization process. So, why not fine tune directly all source model parameters just behind all Linac components to fit the simulation to the measurement? A grid intensity-based surface source model was suggested here, which assumed the particle emitting from the bottom surface of Linac last beam trimmer MLC (Multi Leaf Collimator). The particle emitting position is sampled on the grid intensity map optimized by TPS, and the particle weight is adjusted by its original grid intensity. This source model not only takes advantage of the Monte Carlo method in the heterogeneous media, but also avoids effectively the transportation speed shortcoming of Monte Carlo simulation through Linac components. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Angular dependence of the response of the nanoDot OSLD system for measurements at depth in clinical megavoltage beams

Purpose: The purpose of this investigation was to assess the angular dependence of a commercial optically stimulated luminescence dosimeter (OSLD) dosimetry system in MV x-ray beams at depths beyondd{sub max} and to find ways to mitigate this dependence for measurements in phantoms. Methods: Two special holders were designed which allow a dosimeter to be rotated around the center of its sensitive volume. The dosimeter's sensitive volume is a disk, 5 mm in diameter and 0.2 mm thick. The first holder rotates the disk in the traditional way. It positions the disk perpendicular to the beam (gantry pointing to the floor) in the initial position (0°). When the holder is rotated the angle of the disk towards the beam increases until the disk is parallel with the beam (“edge on,” 90°). This is referred to as Setup 1. The second holder offers a new, alternative measurement position. It positions the disk parallel to the beam for all angles while rotating around its center (Setup 2). Measurements with five to ten dosimeters per point were carried out for 6 MV at 3 and 10 cm depth. Monte Carlo simulations using GEANT4 were performed to simulate the response of the active detector material for several angles. Detector and housing were simulated in detail based on microCT data and communications with the manufacturer. Various material compositions and an all-water geometry were considered. Results: For the traditional Setup 1 the response of the OSLD dropped on average by 1.4% ± 0.7% (measurement) and 2.1% ± 0.3% (Monte Carlo simulation) for the 90° orientation compared to 0°. Monte Carlo simulations also showed a strong dependence of the effect on the composition of the sensitive layer. Assuming the layer to completely consist of the active material (Al{sub 2}O{sub 3}) results in a 7% drop in response for 90° compared to 0°. Assuming the layer to be completely water, results in a flat response within the simulation uncertainty of about 1%. For the new Setup 2, measurements and Monte Carlo simulations found the angular dependence of the dosimeter to be below 1% and within the measurement uncertainty. Conclusions: The dosimeter system exhibits a small angular dependence of approximately 2% which needs to be considered for measurements involving other than normal incident beams angles. This applies in particular to clinicalin vivo measurements where the orientation of the dosimeter is dictated by clinical circumstances and cannot be optimized as otherwise suggested here. When measuring in a phantom, the proposed new setup should be considered. It changes the orientation of the dosimeter so that a coplanar beam arrangement always hits the disk shaped detector material from the thin side and thereby reduces the angular dependence of the response to within the measurement uncertainty of about 1%. This improvement makes the dosimeter more attractive for clinical measurements with multiple coplanar beams in phantoms, as the overall measurement uncertainty is reduced. Similarly, phantom based postal audits can transition from the traditional TLD to the more accurate and convenient OSLD.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Extension of PENELOPE to protons: Simulation of nuclear reactions and benchmark with Geant4

Purpose: Describing the implementation of nuclear reactions in the extension of the Monte Carlo code (MC) PENELOPE to protons (PENH) and benchmarking with Geant4.Methods: PENH is based on mixed-simulation mechanics for both elastic and inelastic electromagnetic collisions (EM). The adopted differential cross sections for EM elastic collisions are calculated using the eikonal approximation with the Dirac–Hartree–Fock–Slater atomic potential. Cross sections for EM inelastic collisions are computed within the relativistic Born approximation, using the Sternheimer–Liljequist model of the generalized oscillator strength. Nuclear elastic and inelastic collisions were simulated using explicitly the scattering analysis interactive dialin database for {sup 1}H and ICRU 63 data for {sup 12}C, {sup 14}N, {sup 16}O, {sup 31}P, and {sup 40}Ca. Secondary protons, alphas, and deuterons were all simulated as protons, with the energy adapted to ensure consistent range. Prompt gamma emission can also be simulated upon user request. Simulations were performed in a water phantom with nuclear interactions switched off or on and integral depth–dose distributions were compared. Binary-cascade and precompound models were used for Geant4. Initial energies of 100 and 250 MeV were considered. For cases with no nuclear interactions simulated, additional simulations in a water phantom with tight resolution (1 mm in all directions) were performed with FLUKA. Finally, integral depth–dose distributions for a 250 MeV energy were computed with Geant4 and PENH in a homogeneous phantom with, first, ICRU striated muscle and, second, ICRU compact bone.Results: For simulations with EM collisions only, integral depth–dose distributions were within 1%/1 mm for doses higher than 10% of the Bragg-peak dose. For central-axis depth–dose and lateral profiles in a phantom with tight resolution, there are significant deviations between Geant4 and PENH (up to 60%/1 cm for depth–dose distributions). The agreement is much better with FLUKA, with deviations within 3%/3 mm. When nuclear interactions were turned on, agreement (within 6% before the Bragg-peak) between PENH and Geant4 was consistent with uncertainties on nuclear models and cross sections, whatever the material simulated (water, muscle, or bone).Conclusions: A detailed and flexible description of nuclear reactions has been implemented in the PENH extension of PENELOPE to protons, which utilizes a mixed-simulation scheme for both elastic and inelastic EM collisions, analogous to the well-established algorithm for electrons/positrons. PENH is compatible with all current main programs that use PENELOPE as the MC engine. The nuclear model of PENH is realistic enough to give dose distributions in fair agreement with those computed by Geant4.

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