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At least 559 records · Page 31

Implementation of rapid diagnostics assays for detection of histoplasmosis and cryptococcosis in central american people living with HIV

Abstract Objectives Histoplasmosis and cryptococcosis are important public health problems in people living with HIV (PLHIV) in Central America. Conventional laboratory assays, based on microscopy and culture, are not optimal for the diagnosis of either disease. However, antigen (Ag) assays are rapid and highly accurate for the diagnosis of these infections. Methods Laboratory surveillance of PLHIV was carried out in four hospitals in Panama, Honduras and Nicaragua, between 2015 and 2019. Detection of Histoplasma antigens in urine was performed by enzyme immunoassay (EIA), and Cryptococcus antigen detection in sera and cerebrospinal fluid specimens was performed by lateral flow assay (LFA). Results A total of 4,453 PLHIV with clinical suspicion of histoplasmosis ( n = 1,343) or cryptococcosis ( n = 3,110; 2,721 sera and 389 CSF) were tested. Of 1,343 patients suspected of having histoplasmosis, 269 (20%) were Histoplasma Ag positive. Of 3,110 patients tested using the Cryptococcus Ag assay, 329 (11%) were positive. Honduras reported the highest positivity rates (32% for Histoplasma Ag, and 16% for Cryptococcus Ag); Panama reported the largest number of patients testing positive using the Histoplasma Ag assay ( n = 201); and Nicaragua reported the largest number of patients testing positive using the Cryptococcus Ag assay ( n = 170). Conclusion Here, we show how the implementation of rapid diagnostics assays impacted case detection and was useful for the care of people with advanced HIV. Rapid and accurate diagnosis could reduce mortality associated with histoplasmosis and cryptococcosis in PLHIV.

Caceres, Diego H.↗

Improved quantitation of SIMS depth profile measurements of niobium via sample holder design improvements and characterization of grain orientation effects

The importance of SIMS analyses for “N-doped” impurity alloyed niobium and other surface-alloyed materials continues to increase. A major hurdle is the uncertainty of instrument calibration due to changes in sample height either from sample surface topography or from the sample holder itself. The CAMECA sample holder design allows for many types of samples to be analyzed. However, a drawback is that the holder faceplate can bend, contributing an uncertainty in the relative sensitivity factor (RSF) used to quantify the SIMS results. Here, we describe an improved sample holder having a reinforced faceplate, which prevents deflection and reduces uncertainty. Simulations show that the new design significantly reduces deflection from 10 μm to 5 nm. Sample measurements show a reduction of RSF uncertainty from this source from 4.1% to 0.95%. Grain orientation has long been suspected to affect RSF measurement as well. A bicrystal implant standard, consisting of randomly oriented and [001] grains, was successively rotated 15° between analyses. It was observed that 20% of the analyses performed on the randomly oriented grain exhibited anomalously high RSF values as well as slow sputter rates. These features were associated with the changing grain normal orientation with respect to the primary Cs + beam. The grain orientation associated with the rise in RSF was simulated and determined to be the [101] crystallographic plane, thus indicating that ion channeling was responsible for the significantly increased RSF. Focused ion beam analysis confirmed slower sputter rates for the cardinal crystallographic orientations, indicating that ion channeling occurred for each.

43 PARTICLE ACCELERATORS↗

Benchmarking large language models for materials synthesis: The case of atomic layer deposition

In this work, we introduce an open-ended question benchmark, ALDbench, to evaluate the performance of large language models (LLMs) in materials synthesis, and, in particular, in the field of atomic layer deposition, a thin film growth technique used in energy applications and microelectronics. Our benchmark comprises questions with a level of difficulty ranging from the graduate level to domain expert current with the state of the art in the field. Human experts reviewed the questions along the criteria of difficulty and specificity, and the model responses along four different criteria: overall quality, specificity, relevance, and accuracy. We ran this benchmark on an instance of OpenAI’s GPT-4o. The responses from the model received a composite quality score of 3.7 on a 1–5 scale, consistent with a passing grade. However, 36% of the questions received at least one below average score. An in-depth analysis of the responses identified at least five instances of suspected hallucination. Finally, we observed statistically significant correlations between the difficulty of the question and the quality of the response, the difficulty of the question and the relevance of the response, the specificity of the question, and the accuracy of the response as graded by the human experts. Furthermore, this emphasizes the need to evaluate LLMs across multiple criteria beyond difficulty or accuracy.

Artificial intelligence↗

The Northwest Infrared (NWIR) gas-phase spectral database of industrial and environmental chemicals: Recent updates

With continuing improvements in both standoff- and point-sensing techniques, there is an ongoing need for high-quality infrared spectral databases. The Northwest Infrared Database (NWIR) contains quantitative, gas-phase infrared spectra of nearly 500 pure chemical species that can be used for a variety of applications such as atmospheric monitoring, biomass burning studies, etc. The data, recorded at 0.1 cm-1 resolution, are pressure broadened to one atmosphere (N2) in order to mimic atmospheric conditions. Each spectrum is a composite composed of multiple individual measurements. Recent updates to the database include over 60 molecules that are known or suspected biomass-burning effluents. Examples from this set of measurements will be presented and experimental details will be discussed in the context of the utility of NWIR for environmental applications.

quantitative infrared spectra, absorption cross-se↗

Hyperspectral vegetation identification at a legacy underground nuclear explosion test site

The detection, location, and identification of suspected underground nuclear explosions (UNEs) are global security priorities that rely on integrated analysis of multiple data modalities for uncertainty reduction in event analysis. Vegetation disturbances may provide complementary signatures that can confirm or build on the observables produced by prompt sensing techniques such as seismic or radionuclide monitoring networks. For instance, the emergence of non-native species in an area may be indicative of anthropogenic activity or changes in vegetation health may reflect changes in the site conditions resulting from an underground explosion. Previously, we collected high spatial resolution (10 cm) hyperspectral data from an unmanned aerial system at a legacy underground nuclear explosion test site and its surrounds. These data consist of visible and near-infrared wavebands over 4.3 km 2 of high desert terrain along with high spatial resolution (2.5 cm) RGB context imagery. In this work, we employ various spectral detection and classification algorithms to identify and map vegetation species in an area of interest containing the legacy test site. Here, we employed a frequentist framework for fusing multiple spectral detections across various reference spectra captured at different times and sampled from multiple locations. The spatial distribution of vegetation species is compared to the location of the underground nuclear explosion. We discover a difference in species abundance within a 130 m radius of the center of the test site.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Image filtering as an alternative to the application of a different reconstruction kernel in CT imaging: Feasibility study in lung cancer screening

Purpose: While the acquisition of projection data in a computed tomography (CT) scanner is generally carried out once, the projection data is often removed from the system, making further reconstruction with a different reconstruction filter impossible. The reconstruction kernel is one of the most important parameters. To have access to all the reconstructions, either prior reconstructions with multiple kernels must be performed or the projection data must be stored. Each of these requirements would increase the burden on data archiving. This study aimed to design an effective method to achieve similar image quality using an image filtering technique in the image space, instead of a reconstruction filter in the projection space for CT imaging. The authors evaluated the clinical feasibility of the proposed method in lung cancer screening. Methods: The proposed technique is essentially the same as common image filtering, which performs processing in the spatial-frequency domain with a filter function. However, the filter function was determined based on the quantitative analysis of the point spread functions (PSFs) measured in the system. The modulation transfer functions (MTFs) were derived from the PSFs, and the ratio of the MTFs was used as the filter function. Therefore, using an image reconstructed with a kernel, an image reconstructed with a different kernel was obtained by filtering, which used the ratio of the MTFs obtained for the two kernels. The performance of the method was evaluated by using routine clinical images obtained from CT screening for lung cancer in five subjects. Results: Filtered images for all combinations of three types of reconstruction kernels (''smooth,''''standard,'' and ''sharp'' kernels) showed good agreement with original reconstructed images regarded as the gold standard. On the filtered images, abnormal shadows suspected as being lung cancers were identical to those on the reconstructed images. The standard deviations (SDs) for the difference between filtered images and reconstructed images ranged from 1.9 to 23.5 Hounsfield units for all kernel combinations; these SDs were much smaller than the noise SDs in the reconstructed images. Conclusions: The proposed method has good performance and is clinically feasible in lung cancer screening. This method can be applied to images reconstructed on any scanner by measuring the PSFs in each system.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Radial differential interior tomography and its image reconstruction with differentiated backprojection and projection onto convex sets

Purpose: Interior tomography has been recognized as one of the most effective approaches in computed tomography (CT) to reduce radiation dose rendered to patients. In this work, the authors propose and evaluate an imaging method of radial differential interior tomography.Methods: In interior tomography, an x-ray beam is collimated to only irradiate the region of interest (ROI) with suspected lesions while the surrounding area/volume of normal tissues/organs is spared. In the proposed imaging method of radial differential interior tomography, the outcome is a ROI image that has gone through a radial differential filtering. The image reconstruction algorithm for the radial differential interior tomography is kept in the fashion of differentiated backprojection and projection onto convex sets, but the required a priori knowledge in a small round area becomes zero and may be more readily available in practice.Results: Using the projection data simulated by computer and acquired by CT scanner, the authors evaluate and verify the performance of the proposed radial differential interior tomography method and its associated image reconstruction algorithm. The preliminary results show that the proposed imaging method can generate an image that is the radial differentiation of a conventional tomographic image and is robust over noise that inevitably exist in practice.Conclusions: It is believed that the proposed imaging method may find its utility in advanced clinical applications wherein a ROI-based image processing and analysis is required for lesion visualization, characterization, and diagnosis.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A complete software application for automatic registration of x-ray mammography and magnetic resonance images

Purpose: This work presents a complete and automatic software application to aid radiologists in breast cancer diagnosis. The application is a fully automated method that performs a complete registration of magnetic resonance (MR) images and x-ray (XR) images in both directions (from MR to XR and from XR to MR) and for both x-ray mammograms, craniocaudal (CC), and mediolateral oblique (MLO). This new approximation allows radiologists to mark points in the MR images and, without any manual intervention, it provides their corresponding points in both types of XR mammograms and vice versa. Methods: The application automatically segments magnetic resonance images and x-ray images using the C-Means method and the Otsu method, respectively. It compresses the magnetic resonance images in both directions, CC and MLO, using a biomechanical model of the breast that distinguishes the specific biomechanical behavior of each one of its three tissues (skin, fat, and glandular tissue) separately. It makes a projection of both compressions and registers them with the original XR images using affine transformations and nonrigid registration methods. Results: The application has been validated by two expert radiologists. This was carried out through a quantitative validation on 14 data sets in which the Euclidean distance between points marked by the radiologists and the corresponding points obtained by the application were measured. The results showed a mean error of 4.2 ± 1.9 mm for the MRI to CC registration, 4.8 ± 1.3 mm for the MRI to MLO registration, and 4.1 ± 1.3 mm for the CC and MLO to MRI registration. Conclusions: A complete software application that automatically registers XR and MR images of the breast has been implemented. The application permits radiologists to estimate the position of a lesion that is suspected of being a tumor in an imaging modality based on its position in another different modality with a clinically acceptable error. The results show that the application can accelerate the mammographic screening process for high risk populations or for dense breasts.

60 APPLIED LIFE SCIENCES↗

SU-D-19A-03: Monte Carlo Investigation of the Mobetron to Perform Modulated Electron Beam Therapy

Purpose: Modulated electron radiotherapy (MERT) has been proposed as a mean of delivering conformal dose to shallow tumors while sparing distal structures and surrounding tissues. In intraoperative radiotherapy (IORT) utilizing Mobetron, an applicator is placed as closely as possible to the suspected cancerous tissues to be treated. In this study we investigate the characteristics of Mobetron electron beams collimated by an in-house prospective electron multileaf collimator (eMLC) and its feasibility for MERT. Methods: IntraOp Mobetron™ dedicated to perform radiotherapy during surgery was used in the study. It provides several energies (6, 9 and 12 MeV). Dosimetry measurements were performed to obtain percentage depth dose curves (PDD) and profiles for a 10-cm diameter applicator using the PTW MP3/XS 3D-scanning system and the semiflex ion chamber. MCBEAM/MCSIM Monte Carlo codes were used for the treatment head simulation and phantom dose calculation. The design of an electron beam collimation by an eMLC attached to the Mobetron head was also investigated using Monte Carlo simulations. Isodose distributions resulting from eMLC collimated beams were compared to that collimated using cutouts. The design for our Mobetron eMLC is based on our previous experiences with eMLCs designed for clinical linear accelerators. For Mobetron the eMLC is attached to the end of a spacer-mounted rectangular applicator at 50 cm SSD. Steel will be used as the leaf material because other materials would be toxic and will not be suitable for intraoperative applications. Results: Good agreement (within 2%) was achieved between measured and calculated PDD curves and profiles for all available energies. Dose distributiosn provided by the eMLC showed reasonable agreement (∼3%/1mm) with those obtained by conventional cutouts. Conclusion: Monte Carlo simulations are capable of modeling Mobetron electron beams with a reliable accuracy. An eMLC attached to the Mobteron treatment head will allow better treatment options with those machines.

60 APPLIED LIFE SCIENCES↗

SU-E-I-30: Image Analysis in Ultrasonography for Diagnosis of Sjoegren's Syndrome Using Dual-Tree Complex Wavelet Transform

Purpose: Sjoegren's syndrome (SS) is an autoimmune disease invading mainly salivary and lacrimal glands. Ultrasonography is used for an initial and non-invasive examination of this disease. However, the ultrasonography diagnosis tends to lack in objectivity and depends on the operator's skills. The purpose of this study is to propose a computer-aided diagnosis (CAD) system for SS based on a dual-tree complex wavelet transform (DT-CWT) and machine learning. Methods: The subjects of this study were 174 patients suspected of having SS at Nagasaki University Hospital and examined with ultrasonography of the parotid glands. Out of these patients, 77 patients were diagnosed with SS by sialography. A region of interest (ROI) of 128 × 128 pixels was set within the parotid gland that was indicated by a dental radiologist. The DT-CWT was applied to the images in the ROI and every image was decomposed into 72 sub-images of the real and imaginary components in six different resolution levels and six orientations. The statistical features of the sub-image were calculated and used as data input for the support vector machine (SVM) classifier for the detection of SS. A ten-fold cross-validation was employed to verify the Resultof SVM. The accuracy of diagnosis was compared by a CAD system with a human observer performance. Results: The sensitivity, specificity, and accuracy in the detection of SS were 95%, 86%, and 91% through our CAD system respectively, while those by a human observer were 84%, 81%, and 83% respectively. Conclusion: The proposed computer-aided diagnosis system for Sjoegren's syndrome in ultrasonography based on dual-tree complex wavelet transform had a better performance than a human observer.

60 APPLIED LIFE SCIENCES↗

Poster — Thur Eve — 57: Evaluation of laryngeal mucosal dose with conventional linac and TomoTherapy

The purpose of this study was to examine whether or not underdosing occurs in the mucosal layer during treatment of glottis cancer. A larynx phantom was produced and regions at risk of recurrence due to suspected underdosing were identified and wells drilled into the phantom for flush placement of TLDs. Seven interest points were chosen. CT simulation was completed prior to the wells being drilled, and again afterwards with the TLD locations indicated using BBs. Treatment plans created for this investigation included: 3DCRT using Elekta-XiO (n=9) and VMAT created using Elekta-Monaco (n=9), both delivered on an Elekta linac; standard TomoTherapy plan (n=11) and a directionally blocked TomoTherapy plan to approximate a 3D-conformal approach (n=5). Imaging dose during TomoTherapy deliveries was accounted for. The average TLD result at each interest point was compared to the planned value using a paired t-test. There was no significant difference between the planned and measured 3DCRT dose (268.9 vs. 267.0 cGy, respectively; p>0.05). Similarly, the planned and measured TomoTherapy treatment did not show any significant differences (271.7 vs 269.7 cGy; p>0.05). In the blocked TomoTherapy plan, significant overdosing was seen (274.5 vs 294.9 cGy; p<0.05) and underdosing was not seen in the VMAT treatment (303.5 vs 321.8 cGy; p>0.05). Further investigation is ongoing to ensure appropriate normalization of results and to investigate the overdosing noted with the blocked TomoTherapy plan. Results from this study suggest that significant underdosing does not occur in the conventional treatment of early glottic cancer using 6MV photons.

60 APPLIED LIFE SCIENCES↗

Poster — Thur Eve — 03: Application of the non-negative matrix factorization technique to [{sup 11}C]-DTBZ dynamic PET data for the early detection of Parkinson's disease

In this work, a class of non-negative matrix factorization (NMF) technique known as alternating non-negative least squares, combined with the projected gradient method, is used to analyze twenty-five [{sup 11}C]-DTBZ dynamic PET/CT brain data. For each subject, a two-factor model is assumed and two factors representing the striatum (factor 1) and the non-striatum (factor 2) tissues are extracted using the proposed NMF technique and commercially available factor analysis software “Pixies”. The extracted factor 1 and 2 curves represent the binding site of the radiotracer and describe the uptake and clearance of the radiotracer by soft tissues in the brain, respectively. The proposed NMF technique uses prior information about the dynamic data to obtain sample time-activity curves representing the striatum and the non-striatum tissues. These curves are then used for “warm” starting the optimization. Factor solutions from the two methods are compared graphically and quantitatively. In healthy subjects, radiotracer uptake by factors 1 and 2 are approximately 35–40% and 60–65%, respectively. The solutions are also used to develop a factor-based metric for the detection of early, untreated Parkinson's disease. The metric stratifies healthy subjects from suspected Parkinson's patients (based on the graphical method). The analysis shows that both techniques produce comparable results with similar computational time. The “semi-automatic” approach used by the NMF technique allows clinicians to manually set a starting condition for “warm” starting the optimization in order to facilitate control and efficient interaction with the data.

60 APPLIED LIFE SCIENCES↗

SU-C-201-04: Quantification of Perfusion Heterogeneity Based On Texture Analysis for Fully Automatic Detection of Ischemic Deficits From Myocardial Perfusion Imaging

Purpose: Texture-based quantification of image heterogeneity has been a popular topic for imaging studies in recent years. As previous studies mainly focus on oncological applications, we report our recent efforts of applying such techniques on cardiac perfusion imaging. A fully automated procedure has been developed to perform texture analysis for measuring the image heterogeneity. Clinical data were used to evaluate the preliminary performance of such methods. Methods: Myocardial perfusion images of Thallium-201 scans were collected from 293 patients with suspected coronary artery disease. Each subject underwent a Tl-201 scan and a percutaneous coronary intervention (PCI) within three months. The PCI Result was used as the gold standard of coronary ischemia of more than 70% stenosis. Each Tl-201 scan was spatially normalized to an image template for fully automatic segmentation of the LV. The segmented voxel intensities were then carried into the texture analysis with our open-source software Chang Gung Image Texture Analysis toolbox (CGITA). To evaluate the clinical performance of the image heterogeneity for detecting the coronary stenosis, receiver operating characteristic (ROC) analysis was used to compute the overall accuracy, sensitivity and specificity as well as the area under curve (AUC). Those indices were compared to those obtained from the commercially available semi-automatic software QPS. Results: With the fully automatic procedure to quantify heterogeneity from Tl-201 scans, we were able to achieve a good discrimination with good accuracy (74%), sensitivity (73%), specificity (77%) and AUC of 0.82. Such performance is similar to those obtained from the semi-automatic QPS software that gives a sensitivity of 71% and specificity of 77%. Conclusion: Based on fully automatic procedures of data processing, our preliminary data indicate that the image heterogeneity of myocardial perfusion imaging can provide useful information for automatic determination of the myocardial ischemia.

60 APPLIED LIFE SCIENCES↗

SU-E-P-33: Critical Role of T2-Weighted Imaging Combined with Diffusion-Weighted Imaging of MRI in Diagnosis of Loco-Regional Recurrent Esophageal Cancer After Radical Surgery

Purpose: We perform this study to investigate the diagnostic efficacy of T2-weighted MRI (T2WI) and diffusion-weighted MRI (DWI) in confirming local relapses of esophageal cancer in patients highly suspected of recurrence after eradicating surgery. Methods: Forty-two postoperative esophageal cancer patients with clinical suspicions of cancer recurrence underwent 3.0T MRI applying axial, coronal, sagittal T2WI and axial DWI sequences. Two experienced radiologists (R1 and R2) both used two methods (T2WI, T2WI+DWI) to observe the images, and graded the patients ranging from 1 to 5 to represent severity of the disease based on visual signal intensity (patients equal to or more than grade 3 was confirmed as recurrent disease) Results: 27/42patients were verified of recurrent disease by pathologic findings and/or imaging findings during follow-up. The sensitivity, specificity and accuracy of R1 applying T2WI+DWI are 96%, 87% and 93% versus 81%, 80% and 77% on T2WI, these figures by R2 were 96%, 93% and 95% versus 89%, 93% and 90%. The receiver operating curve (ROC) analyses suggest that both of the two readers can obtain better accuracy when adding DWI to T2WI compared with T2WI alone. Kappa test between R1 and R2 indicates excellent inter-observer agreement on T2WI+DWI. Conclusion: Standard T2WI in combination DWI can achieve better accuracy than T2WI alone in diagnosing local recurrence of esophageal cancer, and improve consistency between different readers.

60 APPLIED LIFE SCIENCES↗

SU-E-T-546: Modeling and Validation of the a New Proton Therapy System Using a Monte-Carlo Environment Optimized for Protons

8 particle histories were run. Results: Range measurements of the Monte-Carlo simulations matched the measured data within 1mm. Distal fall-off of the simulated fields matched within <1mm. Lateral penumbra and field size measurements of the standard-sized square and half-beam blocked fields matched within 1mm at all three planes compared. A small difference was seen in the in-air profiles at doses <0%. The suspected cause of the difference was the aperture shape. The measured data utilized a divergent aperture. The Monte-Carlo calculation used a non-divergent aperture. Conclusion: The validation measurements indicate that we were able to accurately model the MEVION s250 Proton therapy system using Monte-Carlo Calculations. This may reduce the commissioning time for future users. Purpose: Monte-Carlo modeling is an important tool for understanding the behavior of therapeutic proton beams in a heterogeneous media such as the patient. To gain confidence that a Monte-Carlo model is accurate in complex geometries and media, it must first be compared with measurement in simple situations. This study documents the validation of our Monte-Carlo Model. Methods: A model of the MEVION s250 Proton therapy system was created in the TOPAS Monte-Carlo environment using machine geometry and field shaping system information provided by the vendor. For each of 24 options, validation of the TOPAS model was performed by comparing the dose scored by TOPAS to the dose measurements obtained during the commissioning of the treatment planning system. The measurements compared consisted of: pristine peak depth-dose profiles, in-air profiles for a standard-sized square field (20cm×20cm or 10cm×10cm depending on the maximum field size for each option) at isocenter and at 20cm upstream and downstream of isocenter, and in-air profiles with a half-beam blocked aperture at isocenter and at 20cm upstream and downstream of isocenter. For all Monte-Carlo simulations,.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

WE-AB-BRA-04: Evaluation of the Tumor Registration Error in Biopsy Procedures Performed Under Real Time PET/CT Guidance

Purpose: PET/CT guidance is used for biopsies of metabolically active lesions, which are not well seen on CT alone or to target the metabolically active tissue in tumor ablations. It has also been shown that PET/CT guided biopsies provide an opportunity to verify the location of the lesion border at the place of needle insertion. However the error in needle placement with respect to the metabolically active region may be affected by motion between the PET/CT scan performed at the start of the procedure and the CT scan performed with the needle in place and this error has not been previously quantified. Methods: Specimens from 31 PET/CT guided biopsies were investigated and correlated to the intraoperative PET scan under an IRB approved HIPAA compliant protocol. For 4 of the cases in which larger motion was suspected a second PET scan was obtained with the needle in place. The CT and the PET images obtained before and after the needle insertion were used to calculate the displacement of the voxels along the needle path. CTpost was registered to CTpre using a free form deformable registration and then fused with PETpre. The shifts between the PET image contours (42% of SUVmax) for PETpre and PETpost were obtained at the needle position. Results: For these extreme cases the displacement of the CT voxels along the needle path ranged from 2.9 to 8 mm with a mean of 5 mm. The shift of the PET image segmentation contours (42% of SUVmax) at the needle position ranged from 2.3 to 7 mm between the two scans. Conclusion: Evaluation of the mis-registration between the CT with the needle in place and the pre-biopsy PET can be obtained using deformable registration of the respective CT scans and can be used to indicate the need of a second PET in real-time. This work is supported in part by a grant from Biospace Lab, S.A.

60 APPLIED LIFE SCIENCES↗

A clinically observed discrepancy between image-based and log-based MLC positions

Purpose: To present a clinical case in which real-time intratreatment imaging identified an multileaf collimator (MLC) leaf to be consistently deviating from its programmed and logged position by >1 mm. Methods: An EPID-based exit-fluence dosimetry system designed to prevent gross delivery errors was used to capture cine during treatment images. The author serendipitously visually identified a suspected MLC leaf displacement that was not otherwise detected. The leaf position as recorded on the EPID images was measured and log-files were analyzed for the treatment in question, the prior day’s treatment, and for daily MLC test patterns acquired on those treatment days. Additional standard test patterns were used to quantify the leaf position. Results: Whereas the log-file reported no difference between planned and recorded positions, image-based measurements showed the leaf to be 1.3 ± 0.1 mm medial from the planned position. This offset was confirmed with the test pattern irradiations. Conclusions: It has been clinically observed that log-file derived leaf positions can differ from their actual position by >1 mm, and therefore cannot be considered to be the actual leaf positions. This cautions the use of log-based methods for MLC or patient quality assurance without independent confirmation of log integrity. Frequent verification of MLC positions through independent means is a necessary precondition to trust log-file records. Intratreatment EPID imaging provides a method to capture departures from MLC planned positions.

60 APPLIED LIFE SCIENCES↗

SU-F-R-28: Correction of FCh-PET Bladder Uptake Using Virtual Sinograms and Investigation of Its Impact On the Quantification of Prostate Textural Characteristics

Purpose: Textural biomarkers as a tool for quantifying intratumoral heterogeneity hold great promise for diagnosis and early assessment of treatment response in prostate cancer. However, spill-in counts from the bladder uptake are suspected to have an impact on the textural measurements of the prostate volume. This work proposes a correction method for the FCh-PET bladder uptake and investigates its impact on intraprostatic textural properties. Methods: Two patients with PC received pre-treatment dynamic FCh-PET scans reconstructed at four time points (interval: 2 min), for which prostate and bladder contours were obtained. Projection bins affected by bladder uptake were determined by forward-projection. For each time point and axial position, virtual sinograms were obtained and affected bins replaced by a weighted combination of original values and values interpolated using cubic spline from non-affected bins of the current and adjacent projection angles. The process was optimized using a genetic algorithm in terms of minimization of the root-mean-square error (RMSE) within the bladder between the corrected dynamic time point volume and a reference initial uptake volume. Finally, the impact of the bladder uptake correction on the prostate region was investigated using two standard SUV metrics (1) and three texture metrics (2): 1) SUVmax, SUVmean; 2) Contrast, Homogeneity, Coarseness. Results: Without bladder uptake correction, SUVmax and SUVmean were on average overestimated in the prostate by 0%, 0%, 33.2%, 51.2%, and 3.6%, 6.0%, 2.9%, 3.2%, for each time point respectively. Contrast varied by −9.1%, −6.7%, +40.4%, +107.7%, and Homogeneity and Coarseness by +4.5%, +1.8%, −8.8%, −14.8% and +1.0%, +0.5%, −9.5%, +0.9%. Conclusion: We proposed a method for FCh-PET bladder uptake correction and showed an impact on the quantification of the prostate signal. This method achieved a large reduction of intra-prostatic SUVmax while minimizing the impact on SUVmean. Further investigation is necessary to interpret changes in textural features. SL acknowledges partial support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering Research Council (Grant number: 432290).

60 APPLIED LIFE SCIENCES↗