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At least 505 records · Page 28
All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

Comparison of TG-43 and TG-186 in breast irradiation using a low energy electronic brachytherapy source

Purpose: The recently updated guidelines for dosimetry in brachytherapy in TG-186 have recommended the use of model-based dosimetry calculations as a replacement for TG-43. TG-186 highlights shortcomings in the water-based approach in TG-43, particularly for low energy brachytherapy sources. The Xoft Axxent is a low energy (<50 kV) brachytherapy system used in accelerated partial breast irradiation (APBI). Breast tissue is a heterogeneous tissue in terms of density and composition. Dosimetric calculations of seven APBI patients treated with Axxent were made using a model-based Monte Carlo platform for a number of tissue models and dose reporting methods and compared to TG-43 based plans. Methods: A model of the Axxent source, the S700, was created and validated against experimental data. CT scans of the patients were used to create realistic multi-tissue/heterogeneous models with breast tissue segmented using a published technique. Alternative water models were used to isolate the influence of tissue heterogeneity and backscatter on the dose distribution. Dose calculations were performed using Geant4 according to the original treatment parameters. The effect of the Axxent balloon applicator used in APBI which could not be modeled in the CT-based model, was modeled using a novel technique that utilizes CAD-based geometries. These techniques were validated experimentally. Results were calculated using two dose reporting methods, dose to water (D{sub w,m}) and dose to medium (D{sub m,m}), for the heterogeneous simulations. All results were compared against TG-43-based dose distributions and evaluated using dose ratio maps and DVH metrics. Changes in skin and PTV dose were highlighted. Results: All simulated heterogeneous models showed a reduced dose to the DVH metrics that is dependent on the method of dose reporting and patient geometry. Based on a prescription dose of 34 Gy, the average D{sub 90} to PTV was reduced by between ∼4% and ∼40%, depending on the scoring method, compared to the TG-43 result. Peak skin dose is also reduced by 10%–15% due to the absence of backscatter not accounted for in TG-43. The balloon applicator also contributed to the reduced dose. Other ROIs showed a difference depending on the method of dose reporting. Conclusions: TG-186-based calculations produce results that are different from TG-43 for the Axxent source. The differences depend strongly on the method of dose reporting. This study highlights the importance of backscatter to peak skin dose. Tissue heterogeneities, applicator, and patient geometries demonstrate the need for a more robust dose calculation method for low energy brachytherapy sources.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

SU-E-T-53: Benchmarking a Monte Carlo Model for Patient Plane Leakage Calculations of Low Energy 6MV Unique Linacs

Purpose: To validate the physics parameters of a Monte Carlo model for patient plane leakage calculations on the 6MV Unique linac by comparing the simulations against IEC patient plane leakage measurements. The benchmarked model can further be used for shielding design optimization, to predict leakage in the proximity of intended treatment fields, reduce the system weight and cost, and improve components reliability. Methods: The treatment head geometry of the Unique linac was simulated in Geant4 (v9.4.p02 with “Opt3” standard electromagnetic physics list) based on CAD drawings of all collimation and shielding components projected from the target to the area within 2m from isocenter. A 4×4m2 scorer was inserted 1m from the target in the patient plane and multiple phase space files were recorded by performing a 40-node computing cluster simulation on the EC2 cloud. The photon energy fluence was calculated relative to the value at isocenter for a 10×10cm2 field using 10×10mm2 bins. Tungsten blocks were parked accordingly to represent MLC120. The secondary particle contamination to patient plane was eliminated by “killing” those particles prior to the primary collimator entrance using a “kill-plane”, which represented the upper head shielding components not being modeled. Both IEC patient-plane leakage and X/Y-jaws transmission were simulated. Results: The contribution of photons to energy fluence was 0.064% on average, in excellent agreement with the experimental data available at 0.5, 1.0, and 1.5m from isocenter, characterized by an average leakage of 0.045% and a maximum leakage of 0.085%. X- and Y-jaws transmissions of 0.43% and 0.44% were found in good agreement with measurements of 0.48% and 0.43%, respectively. Conclusion: A Geant4 model based on energy fluence calculations for the 6MV Unique linac was created and validated using IEC patient plane leakage measurements. The “kill-plane” has effectively eliminated electron contamination to patient plane in these simulations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-284: Revisiting Reference Dosimetry for the Model S700 Axxent 50 KV{sub p} Electronic Brachytherapy Source

Purpose: The model S700 Axxent electronic brachytherapy source by Xoft was characterized in 2006 by Rivard et al. The source design was modified in 2006 to include a plastic centering insert at the source tip to more accurately position the anode. The objectives of the current study were to establish an accurate Monte Carlo source model for simulation purposes, to dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and to determine dose differences between the source with and without the centering insert. Methods: Design information from dissected sources and vendor-supplied CAD drawings were used to devise the source model for radiation transport simulations of dose distributions in a water phantom. Collision kerma was estimated as a function of radial distance, r, and polar angle, θ, for determination of reference TG-43 dosimetry parameters. Simulations were run for 10{sup 10} histories, resulting in statistical uncertainties on the transverse plane of 0.03% at r=1 cm and 0.08% at r=10 cm. Results: The dose rate distribution the transverse plane did not change beyond 2% between the 2006 model and the current study. While differences exceeding 15% were observed near the source distal tip, these diminished to within 2% for r>1.5 cm. Differences exceeding a factor of two were observed near θ=150° and in contact with the source, but diminished to within 20% at r=10 cm. Conclusions: Changes in source design influenced the overall dose rate and distribution by more than 2% over a third of the available solid angle external from the source. For clinical applications using balloons or applicators with tissue located within 5 cm from the source, dose differences exceeding 2% were observed only for θ>110°. This study carefully examined the current source geometry and presents a modern reference TG-43 dosimetry dataset for the model S700 source.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-F-16A-01: Commissioning and Clinical Use of PC-ISO for Customized, 3D Printed, Gynecological Brachytherapy Applicators

Purpose: (1) Evaluate the safety and radiation attenuation properties of PCISO, a bio-compatible, sterilizable 3D printing material by Stratasys, (2) establish a method for commissioning customized multi- and single-use 3D printed applicators, (3) report on use of customized vaginal cylinders used to treat a series of serous endometrial cancer patient. Methods: A custom film dosimetry apparatus was designed to hold a Gafchromic radio film segment between two blocks of PC-ISO and 3D-printed using a Fortus 400mc (StrataSys). A dose plan was computed using 13 dwell positions at 2.5 mm spacing and normalized to 1500 cGy at 1 cm. Film exposure was compared to control tests in only air and only water. The average Hounsfield Unit (HU) was computed and used to verify water equivalency. For the clinical use cases, the physician specifies the dimensions and geometry of a custom applicator from which a CAD model is designed and printed. Results: The doses measured from the PC-ISO Gafchromic film test were within 1% of the dose measured in only water between 1cm and 6cm from the channel. Doses increased 7–4% measured in only air. HU range was 11–43. The applicators were sterilized using the Sterrad system multiple times without damage. As of submission 3 unique cylinders have been designed, printed, and used in the clinic. A standardizable workflow for commissioning custom 3D printed applicators was codified and will be reported. Conclusions: Quality assurance (QA) evaluation of the PC-ISO 3D-printing material showed that PC-ISO is a suitable material for a gynecological brachytherapy vaginal cylinder in a clinical setting. With the material commissioning completed, if the physician determines that a better treatment would Result, a customized design is fabricated with limited additional QA necessary. Although this study was specific to PC-ISO, the same setup can be used to evaluate other 3D-printing materials.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model

Purpose: The model S700 Axxent electronic brachytherapy source by Xoft, Inc., was characterized by Rivard et al. in 2006. Since then, the source design was modified to include a new insert at the source tip. Current study objectives were to establish an accurate source model for simulation purposes, dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and determine dose differences between the original simulation model and the current model S700 source design. Methods: Design information from measurements of dissected model S700 sources and from vendor-supplied CAD drawings was used to aid establishment of an updated Monte Carlo source model, which included the complex-shaped plastic source-centering insert intended to promote water flow for cooling the source anode. These data were used to create a model for subsequent radiation transport simulations in a water phantom. Compared to the 2006 simulation geometry, the influence of volume averaging close to the source was substantially reduced. A track-length estimator was used to evaluate collision kerma as a function of radial distance and polar angle for determination of TG-43 dosimetry parameters. Results for the 50 kV source were determined every 0.1 cm from 0.3 to 15 cm and every 1° from 0° to 180°. Photon spectra in water with 0.1 keV resolution were also obtained from 0.5 to 15 cm and polar angles from 0° to 165°. Simulations were run for 10{sup 10} histories, resulting in statistical uncertainties on the transverse plane of 0.04% at r = 1 cm and 0.06% at r = 5 cm. Results: The dose-rate distribution ratio for the model S700 source as compared to the 2006 model exceeded unity by more than 5% for roughly one quarter of the solid angle surrounding the source, i.e., θ ≥ 120°. The radial dose function diminished in a similar manner as for an {sup 125}I seed, with values of 1.434, 0.636, 0.283, and 0.0975 at 0.5, 2, 5, and 10 cm, respectively. The radial dose function ratio between the current and the 2006 model had a minimum of 0.980 at 0.4 cm, close to the source sheath and for large distances approached 1.014. 2D anisotropy function ratios were close to unity for 50° ≤ θ ≤ 110°, but exceeded 5% for θ < 40° at close distances to the sheath and exceeded 15% for θ > 140°, even at large distances. Photon energy fluence of the updated model as compared to the 2006 model showed a decrease in output with increasing distance; this effect was pronounced at the lowest energies. A decrease in photon fluence with increase in polar angle was also observed and was attributed to the silver epoxy component. Conclusions: Changes in source design influenced the overall dose rate and distribution by more than 2% in several regions. This discrepancy is greater than the dose calculation acceptance criteria as recommended in the AAPM TG-56 report. The effect of the design change on the TG-43 parameters would likely not result in dose differences outside of patient applicators. Adoption of this new dataset is suggested for accurate depiction of model S700 source dose distributions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-C-213-07: Fabrication and Testing of a 3D-Printed Small Animal Rectal Cooling Device to Evaluate Local Hypothermia as a Radioprotector During Prostate SBRT

Purpose: The protective effects of induced or even accidental hypothermia on the human body are widespread with several medical uses currently under active research. In vitro experiments using human cell lines have shown hypothermia provides a radioprotective effect that becomes more pronounced at large, single-fraction doses common to SBRT treatments. Relevant to prostate SBRT, this work details the fabrication and testing of a 3D-printed cooling device to facilitate the investigation of the radioprotective effect of local hypothermia on the rat rectum. Methods: A 3cm long, two-channel rectal cooling device was designed in SOLIDWORKS CAD for 3D printing. The water intake nozzle is connected to a 1mm diameter brass pipe from which water flows and circulates back around to the exit nozzle. Both nozzles are connected by plastic tubing to a water chiller pump. Following leak-proof testing, fiber optic temperature probes were used to evaluate the temperature over time when placed adjacent to the cooling device within a rat rectum. MRI thermometry characterized the relative temperature distribution in concentric ROIs surrounding the probe. CBCT images from a small-animal irradiator were evaluated for imaging artifacts which could affect Monte Carlo dose calculations during treatment planning. Results: The rectal temperature adjacent to the cooling device decreased from body temperature (37°C) to 15°C in 10–20 minutes from device insertion. Rectal temperature was maintained at 15±3°C during active cooling. MRI thermometry tests revealed a steep temperature gradient with increasing distance from the cooling device, with the desired temperature range maintained within the surrounding few millimeters. Conclusion: A 3D printed rectal cooling device was fabricated for the purpose of inducing local hypothermia in rat rectums. Rectal cooling capabilities were characterized in-vivo to facilitate an investigation of the radioprotective effect of hypothermia for late rectal toxicity following a single large dose of radiation. Funding support provided by RSNA research seed grant.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-61: A Practical Process for Fabricating Passive Scatter Proton Beam Modulation Compensation Filters Using 3D Printing

Purpose: The purpose of this project was to devise a practical fabrication process for passive scatter proton beam compensation filters (CF) that is competitive in time, cost and effort using 3D printing. Methods: DICOM compensator filter files for a proton beam were generated by our Eclipse (Varian, Inc.) treatment planning system. The compensator thickness specifications were extracted with in-house software written in Matlab (MathWorks, Inc.) code and written to a text file which could be read by the Rhinoceros 5, computer-aided design (CAD) package (Robert McNeel and Associates), which subsequently generated a smoothed model in a STereoLithographic also known as a Standard Tesselation Language file (STL). The model in the STL file was subsequently refined using Netfabb software and then converted to printing instructions using Cura. version 15.02.1. for our 3D printer. The Airwolf3D, model HD2x, fused filament fabrication (FFF) 3D printer (Airwolf3D.com) was used for our fabrication system with a print speed of 150mm per second. It can print in over 22 different plastic filament materials in a build volume of 11” x 8” x 12”. We choose ABS plastic to print the 3D model of the imprint for our CFs. Results: Prints of the CF could be performed at a print speed of 70mm per second. The time to print the 3D topology for the CF for the 14 cm diameter snout of our Mevion 250 proton accelerator was less than 3 hours. The printed model is intended to subsequently be used as a mold to imprint a molten wax cylindrical to form the compensation after cooling. The whole process should be performed for a typical 3 beam treatment plan within a day. Conclusion: Use of 3D printing is practical and can be used to print a 3D model of a CF within a few hours.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

SU-E-T-124: Anthropomorphic Phantoms for Confirmation of Linear Accelerator Based Small Animal Irradiation

Purpose: To document the support of radiobiological small animal research by a modern radiation oncology facility. This study confirms that a standard, human use linear accelerator can cover the range of experiments called for by researchers performing animal irradiation. A number of representative, anthropomorphic murine phantoms were made. The phantoms confirmed the small field photon and electron beams dosimetry validated the use of the linear accelerator for rodents. Methods: Laser scanning a model, CAD design and 3D printing produced the phantoms. The phantoms were weighed and CT scanned to judge their compatibility to real animals. Phantoms were produced to specifically mimic lung, gut, brain, and othotopic lesion irradiations. Each phantom was irradiated with the same protocol as prescribed to the live animals. Delivered dose was measured with small field ion chambers, MOS/FETs or TLDs. Results: The density of the phantom material compared to density range across the real mice showed that the printed material would yield sufficiently accurate measurements when irradiated. The whole body, lung and gut irradiations were measured within 2% of prescribed doses with A1SL ion chamber. MOSFET measurements of electron irradiations for the orthotopic lesions allowed refinement of the measured small field output factor to better than 2% and validated the immunology experiment of irradiating one lesion and sparing another. Conclusion: Linacs are still useful tools in small animal bio-radiation research. This work demonstrated a strong role for the clinical accelerator in small animal research, facilitating standard whole body dosing as well as conformal treatments down to 1cm field. The accuracy of measured dose, was always within 5%. The electron irradiations of the phantom brain and flank tumors needed adjustment; the anthropomorphic phantoms allowed refinement of the initial output factor measurements for these fields which were made in a large block of solid water.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

MO-F-CAMPUS-J-04: Radiation Heat Load On the MR System of the Elekta Atlantic System

Purpose: The Elekta Atlantic system combines a digital linear accelerator system with a 1.5T Philips MRI machine.This study aimed to assess the energy deposited within the cryostat system when the radiation beam passes through the cryostat. The cryocooler on the magnet has a cooling capacity which is about 1 Watt in excess of the cryogenic heat leak into the magnet’s cold mass. A pressure-controlled heater inside the magnet balances the excess refrigeration power such that the helium pressure in the tank is kept slightly above ambient air pressure. If radiation power is deposited in the cold mass then this heater will need less power to maintain pressure equilibrium and if the radiation heat load exceeds the excess cryocooler capacity the pressure will rise. Methods: An in-house CAD based Monte Carlo code based on Penelope was used to model the entire MR-Linac system to quantify the heat load on the magnet’s cold mass. These results were then compared to experimental results obtained from an Elekta Atlantic system installed in UMC-Utrecht. Results: For a field size of 25 cm x 22 cm and a dose rate of 107 mu.min-1, the energy deposited by the radiation beam led to a reduction in heater power from 1.16 to 0.73 W. Simulations predicted a reduction to 0.69 W which is in good agreement. For the worst case field size (largest) and maximum dose rate the cryostat cooler capacity was exceeded. This resulted in a pressure rise within the system but was such that continuous irradiation for over 12 hours would be required before the magnet would start blowing off helium. Conclusion: The study concluded that the Atlantic system does not have to be duty cycle restricted, even for the worst case non-clinical scenario and that there are no adverse effects on the MR system. Stephen Towe and David Roberts Both work for Elekta; Ezra Van Lanen works for Philips Healthcare; Johan Overweg works for Philips Innovative Technologies.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-CD-304-05: 4Ï€ Non-Coplanar Radiotherapy: From Mathematical Modeling to Clinical Implementation

Purpose: To develop and clinically implement 4π radiotherapy, an inverse optimization platform that maximally utilizes non-coplanar intensity modulated radiotherapy (IMRT) beams to significantly improve critical organ sparing. Methods: A 3D scanner was used to digitize the human and phantom subject surfaces, which were positioned in the computer assisted design (CAD) model of a TrueBeam machine to create a virtual geometrical model, based on which, the feasible beam space was calculated for different tumor locations. Beamlets were computed for all feasible beams using convolution/superposition. A column generation algorithm was employed to optimize patient specific beam orientations and fluence maps. Optimal routing through all selected beams were calculated by a level set method. The resultant plans were converted to XML files and delivered to phantoms in the TrueBeam developer mode. Finally, 4π plans were recomputed in Eclipse and manually delivered to recurrent GBM patients. Results: Compared to IMRT utilizing manually selected beams and volumetric modulated arc therapy plans, markedly improved dosimetry was observed using 4π for the brain, head and neck, liver, lung, and prostate patients. The improvements were due to significantly improved conformality and reduced high dose spillage to organs mediolateral to the PTV. The virtual geometrical model was experimentally validated. Safety margins with 99.9% confidence in collision avoidance were included to the model based model accuracy estimates determined via 300 physical machine to phantom distance measurements. Automated delivery in the developer mode was completed in 10 minutes and collision free. Manual 4 π treatment on the GBM cases resulted in significant brainstem sparing and took 35–45 minutes including multiple images, which showed submillimeter cranial intrafractional motion. Conclusion: The mathematical modeling utilized in 4π is accurate to create and guide highly complex non-coplanar IMRT treatments that consistently and significantly outperform human-operator-created plans. Deliverability of such plans is clinically demonstrated. This work is funded by Varian Medical Systems and the NSF Graduate Research Fellowship DGE-1144087.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Technical Note: Immunohistochemical evaluation of mouse brain irradiation targeting accuracy with 3D-printed immobilization device

Purpose: Small animal immobilization devices facilitate positioning of animals for reproducible imaging and accurate focal radiation therapy. In this study, the authors demonstrate the use of three-dimensional (3D) printing technology to fabricate a custom-designed mouse head restraint. The authors evaluate the accuracy of this device for the purpose of mouse brain irradiation. Methods: A mouse head holder was designed for a microCT couch using CAD software and printed in an acrylic based material. Ten mice received half-brain radiation while positioned in the 3D-printed head holder. Animal placement was achieved using on-board image guidance and computerized asymmetric collimators. To evaluate the precision of beam localization for half-brain irradiation, mice were sacrificed approximately 30 min after treatment and brain sections were stained for γ-H2AX, a marker for DNA breaks. The distance and angle of the γ-H2AX radiation beam border to longitudinal fissure were measured on histological samples. Animals were monitored for any possible trauma from the device. Results: Visualization of the radiation beam on ex vivo brain sections with γ-H2AX immunohistochemical staining showed a sharp radiation field within the tissue. Measurements showed a mean irradiation targeting error of 0.14 ± 0.09 mm (standard deviation). Rotation between the beam axis and mouse head was 1.2° ± 1.0° (standard deviation). The immobilization device was easily adjusted to accommodate different sizes of mice. No signs of trauma to the mice were observed from the use of tooth block and ear bars. Conclusions: The authors designed and built a novel 3D-printed mouse head holder with many desired features for accurate and reproducible radiation targeting. The 3D printing technology was found to be practical and economical for producing a small animal imaging and radiation restraint device and allows for customization for study specific needs.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Simulation evaluation of NIST air-kerma rate calibration standard for electronic brachytherapy: Simulation of NIST air-kerma rate eBT calibration standard

Purpose: Dosimetry for the model S700 50 kV electronic brachytherapy (eBT) source (Xoft, Inc., a subsidiary of iCAD, San Jose, CA) was simulated using Monte Carlo (MC) methods by Rivard et al. [“Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent x-ray source: An electronic brachytherapy source,” Med. Phys. 33, 4020–4032 (2006)] and recently by Hiatt et al. [“A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model,” Med. Phys. 42, 2764–2776 (2015)] with improved geometric characterization. Additionally, while these studies examined the dose distribution in water, there have not previously been reports of the eBT source calibration methods beyond that recently reported by Seltzer et al. [“New national air-kerma standard for low-energy electronic brachytherapy sources,” J. Res. Natl. Inst. Stand. Technol. 119, 554–574 (2014)]. Therefore, the motivation for the current study was to provide an independent determination of air-kerma rate at 50 cm in air K air (d = 50 cm) using MC methods for the model S700 eBT source. Methods: Using CAD information provided by the vendor and disassembled sources, an MC model was created for the S700 eBT source. Simulations were run using the mcnp6 radiation transport code for the NIST Lamperti air ionization chamber according to specifications by Boutillon et al. [“Comparison of exposure standards in the 10-50 kV x-ray region,” Metrologia 5, 1–11 (1969)], in air without the Lamperti chamber, and in vacuum without the Lamperti chamber. K air (d = 50 cm) was determined using the *F4 tally with NIST values for the mass energy-absorption coefficients for air. Photon spectra were evaluated over 2π azimuthal sampling for polar angles of 0° ≤ θ ≤ 180° every 1°. Volume averaging was averted through tight radial binning. Photon energy spectra were determined over all polar angles in both air and vacuum using the F4 tally with 0.1 keV resolution. A total of 10 11 simulated histories were run for the Lamperti chamber geometry (statistical uncertainty of 0.14%), with 10 10 histories for the in-air and in-vacuum simulations (statistical uncertainty of 0.04%). The total standard uncertainty in the calculated air-kerma rate determination amounted to 6.8%. Results: MC simulations determined the air-kerma rate at 50 cm from the source with the modeled Lamperti chamber to be (1.850 ± 0.126) × 10 -4 Gy/s, which was within the range of K air (d = 50 cm) values (1.67–2.11) × 10 -4 Gy/s measured by NIST. The ratio of the photon spectra in air and in vacuum were in good agreement above 13 keV, and for θ < 150° where the influence of the Kovar sleeve and the Ag epoxy components caused increased scatter in air. Below 13 keV, the ratio of the photon spectra in air to vacuum exhibited a decrease that was attributed to increased attenuation of the photons in air. Across most of the energy range on the source transverse plane, there was good agreement between the authors' simulated spectra and that measured by NIST. Discrepancies were observed above 40 keV where the NIST spectrum had a steeper fall-off towards 50 keV. Conclusions: Through MC simulations of radiation transport, this study provided an independent validation of the measured air-kerma rate at 50 cm in air at NIST for the model S700 eBT source, with mean results in agreement within 3.3%. Lastly, this difference was smaller than the range (i.e., 23%) of the measured values.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2016

SU-F-E-13: Design and Fabrication of Gynacological Brachytherapy Shielding & Non Shielding Applicators Using Indigenously Developed 3D Printing Machine

Purpose: In this innovative work we have developed Gynecological Brachytherapy shielding & Non Shielding Applicators and compared with the commercially available applicators by using the indigenously developed 3D Printing machine. Methods: We have successfully indigenously developed the 3D printing machine. Which contain the 3 dimensional motion platform, Heater unit, base plate, ect… To fabricate the Gynecological Brachytherapy shielding & non shielding applicators the 3D design were developed in the computer as virtual design. This virtual design is made in a CAD computer file using a 3D modeling program. Separate programme for the shielding & non shielding applicators. We have also provided the extra catheter insert provision in the applicator for the multiple catheter. The DICOM file of the applicator were then converted to stereo Lithography file for the 3D printer. The shielding & Non Shielding Applicators were printed on a indigenously developed 3D printer material. The same dimensions were used to develop the applicators in the acrylic material also for the comparative study. A CT scan was performed to establish an infill-density calibration curve as well as characterize the quality of the print such as uniformity and the infill pattern. To commission the process, basic CT and dose properties of the printing materials were measured in photon beams and compared against water and soft tissue. Applicator were then scanned to confirm the placement of multiple catheter position. Finally dose distributions with rescanned CTs were compared with those computer-generated applicators. Results: The doses measured from the ion Chamber and X-Omat film test were within 2%. The shielded applicator reduce the rectal dose comparatively with the non shielded applicator. Conclusion: As of submission 3 unique cylinders have been designed, printed, and tested dosimetrically. A standardizable workflow for commissioning custom 3D printed applicators was codified and will be reported.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-53: A 3D Printed Phantom for the Use of Daily Quality Assurance Alignment Tests

Purpose: To discuss experiences and results for a 3D printed QA phantom used for daily alignment purposes for a six degrees-of-freedom (6DoF) table Methods: A 3D model was created using a fused deposition modeling (FDM) printer using free online computer-aided design (CAD) software. The model has been under use for daily QA alignment tests for a 6DoF couch. An aligned and angled baseplate were also printed in order to introduce known angles for 6DoF corrections during image-guidance. Unique registration contours were created on the faces of the phantom in order to achieve a better cone-beam computed tomography (CBCT) match using an auto-registration algorithm. A BB was also introduced at the center of the phantom in order to deliver an integrated daily Winston-Lutz (WL) test. Translational, rotational, and WL results were tabulated over one month. Results: The ’honeycomb’ structure of the print was apparent in the EPID images for the WL test, which affected the results of the analysis software. This was fixed by inserting a cube made of polyoxymethylene within the 3D phantom that encompass the BB. Auto-registration results for the three translational and three rotational from a known offset to the BB isocenter consistently fell within 1 mm and 0.2°, respectively. WL tests resulted in an average of 0.71 ± 0.14 mm. Conclusion: 3D printed models allow for accurate builds that can be customized to a variety of clinical needs. Results from translational, rotational, and WL show consistent results over a month’s time. Given its relatively cheap and streamlined workflow, 3D printing could be implemented into any clinic looking to create customized phantoms.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-J-149: Beam and Cryostat Scatter Characteristics of the Elekta MR-Linac

Purpose: The Elekta MR-Linac combines a digital linear accelerator system with a 1.5T Philips MRI machine. This study aimed to determine key characteristic information regarding the MR-Linac beam and in particular it evaluated the effect of the MR cryostat on the out of field scatter dose. Methods: Tissue phantom ratios, profiles and depth doses were acquired in plastic water with an IC-profiler or with an MR compatible water tank using multiple system configurations (Full (B0= 1.5T), Full (B0=0T) and No cryostat). Additionally, an in-house CAD based Monte Carlo code based on Penelope was used to provide comparative data. Results: With the cryostat in place and B0=0T, the measured TPR for the MR Linac system was 0.702, indicating an energy of around 7MV. Without the cryostat, the measured TPR was 0.669. For the Full (B0=0T) case, out of field dose at a depth of 10 cm in the isocentric plane, 5 cm from the field edge was 0.8%, 3.1% and 5.4% for 3×3 cm{sup 2}, 10×10 cm{sup 2} and 20×20 cm{sup 2} fields respectively.The out of field dose (averaged between 5 cm and 10 cm beyond the field edges) in the “with cryostat” case is 0.78% (absolute difference) higher than without the cryostat for clinically relevant field sizes (i.e. 10×10 cm{sup 2}) and comparable to measured conventional 6MV treatment beams at a depth of 10 cm (within 0.1% between 5 cm and 6 cm from field edge). At dose maximum and at 5 cm from the field edge, the “with cryostat” out of field scatter for a 10×10 cm{sup 2} field is 1.5% higher than “without cryostat', with a modest increase (0.9%) compared to Agility 6MV in the same conditions. Conclusion: The study has presented typical characteristics of the MR-Linac beam and determined that out of field dose is comparable to conventional treatment beams. All authors are employed by Elekta Ltd., who are developing an MR-Linac.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-111: Investigation of the Attila Deterministic Solver as a Supplement to Monte Carlo for Calculating Out-Of-Field Radiotherapy Dose

Purpose: To use the Attila deterministic solver as a supplement to Monte Carlo for calculating out-of-field organ dose in support of epidemiological studies looking at the risks of second cancers. Supplemental dosimetry tools are needed to speed up dose calculations for studies involving large-scale patient cohorts. Methods: Attila is a multi-group discrete ordinates code which can solve the 3D photon-electron coupled linear Boltzmann radiation transport equation on a finite-element mesh. Dose is computed by multiplying the calculated particle flux in each mesh element by a medium-specific energy deposition cross-section. The out-of-field dosimetry capability of Attila is investigated by comparing average organ dose to that which is calculated by Monte Carlo simulation. The test scenario consists of a 6 MV external beam treatment of a female patient with a tumor in the left breast. The patient is simulated by a whole-body adult reference female computational phantom. Monte Carlo simulations were performed using MCNP6 and XVMC. Attila can export a tetrahedral mesh for MCNP6, allowing for a direct comparison between the two codes. The Attila and Monte Carlo methods were also compared in terms of calculation speed and complexity of simulation setup. A key perquisite for this work was the modeling of a Varian Clinac 2100 linear accelerator. Results: The solid mesh of the torso part of the adult female phantom for the Attila calculation was prepared using the CAD software SpaceClaim. Preliminary calculations suggest that Attila is a user-friendly software which shows great promise for our intended application. Computational performance is related to the number of tetrahedral elements included in the Attila calculation. Conclusion: Attila is being explored as a supplement to the conventional Monte Carlo radiation transport approach for performing retrospective patient dosimetry. The goal is for the dosimetry to be sufficiently accurate for use in retrospective epidemiological investigations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-H-BRA-03: Performance of a Clinical Gridded Electron Gun in Magnetic Fields: Implications for MRI-Linac Therapy

Purpose: Recent advances towards MRI Linac radiotherapy have motivated a wide range of studies characterizing electromagnetic interactions between the two devices. One of the most sensitive components is the linac electron gun. To data, only non gridded (diode) guns have been investigated however, most linac vendors utilize gridded (triode) guns, which enable efficient and robust beam gating. The purpose of this study was to develop a realistic model of a gridded gun used clinically, and to characterize its performance in magnetic fields. Methods: The gridded electron gun used on Varian high energy machines was measured using 3D laser scanning quoted as accurate to 0.1mm. Based on the scane, a detailed CAD mode was developed. From this, key geometry was extracted and a FEM model was developed (Opera/SCALA). Next, the high voltage (HV), grid voltage, and emission current were read from six dose matched TrueBeam linacs for the 6X, 10X and 15X photon modes (0 B-field). The mean values were used to represent each mode, which was simulated I constant magnetic fields from 0–200G in-line, and 0–35G perpendicular. Results: Experimentally measured HV, grid voltage, and emission current from 6X, 10X and 15X modes were respectively: 15±.03kV, 10±.08kV, 11±.03kV; 93±7V, 41±3V, and 70±6V; 327±27mA, 129±10mA, and 214±19mA. The error in simulated emission current of each mode was 3%,6%, and 3%. For in-line fields, 50% beam loss occurred at 114, 96, and 97G; for perpendicular; at 12, 13 and 14G. Sensitivity for a given geometry is primarily determined by HV setting. Conclusion: Future MRI-Linac systems will almost certainly use gridded guns. We present the first model of a clinical gridded gun, and match the experimental emission current to within 6% across three different operating modes. This clinical gun shows increased sensitivity to magnetic fields than previous work,and different modes show different sensitivity.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

TU-H-206-02: Novel Linearly-Filled Derenzo PET Phantom Design

Purpose: To design a linearly-filled Derenzo positron emission tomography (PET) phantom, eliminating the extraneous radioisotope volumes in a conventional reservoir-type design. This activity reduction combined with the elimination of bubbles in smaller phantom channels would significantly reduce personnel dose, radioisotope cost, and would improve image quality by reducing out-of-slice activity scatter. Methods: A computer-aided design (CAD) was created of a modular Derenzo phantom consisting of three phantom layers with gaskets between the layers. The central piece contains the active pattern volume and channels connecting adjacent rods in a serpentine pattern. The two end-pieces contained an inlet and an outlet for filling purposes. Phantom prototypes were 3D printed on a Viper Si2 stereolithography machine. The two gaskets were fabricated from silicon sheets using a PLS 6.75 laser cutter. Phantoms were held together by pass-through glass-filled nylon bolts and nuts. Phantoms were filled with {sup 52}Mn, {sup 64}Cu, {sup 74}Br, and {sup 124}I for testing, and were imaged on a Siemens Inveon MicroPET scanner. Results: Four phantom prototypes were constructed using male Leur Lock fittings for inlet/outlet ports. 3D printed layers were sanded to ensure proper coupling to the silicon gaskets. The filling volume for each prototype was approximately 2.4 mL. The filling process was found to be rapid, leak-tight, and with minimal back-pressure. PET images were reconstructed by OSEM3D, and axial slices along the phantom pattern length were averaged to provide final images. Image distortion was isotope dependent with {sup 52}Mn and {sup 64}Cu having the least distortion and {sup 124}I having the most distortion. Conclusion: These results indicate that the linearlyfilled Derenzo design improves on conventional reservoir-type designs by eliminating potential bubbles in small channels and by reducing activity level, radioisotope volume, radioisotope cost, personnel dose, filling time, and out-of-slice activity scatter The method described in this abstract has been filed as a patent application to the US Patent and Trade Office by the Wisconsin Alumni Research Foundation (WARF).

60 APPLIED LIFE SCIENCES↗