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At least 631 records · Page 35
All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

MO-G-BRF-09: Investigating Magnetic Field Dose Effects in Mice: A Monte Carlo Study

Purpose: In MRI-linac treatments, radiation dose distributions are affected by magnetic fields, especially at high-density/low-density interfaces. Radiobiological consequences of magnetic field dose effects are presently unknown; therefore, preclinical studies are needed to ensure the safe clinical use of MRI-linacs. This study investigates the optimal combination of beam energy and magnetic field strength needed for preclinical murine studies. Methods: The Monte Carlo code MCNP6 was used to simulate the effects of a magnetic field when irradiating a mouse-sized lung phantom with a 1.0cmx1.0cm photon beam. Magnetic field effects were examined using various beam energies (225kVp, 662keV[Cs-137], and 1.25MeV[Co-60]) and magnetic field strengths (0.75T, 1.5T, and 3T). The resulting dose distributions were compared to Monte Carlo results for humans with various field sizes and patient geometries using a 6MV/1.5T MRI-linac. Results: In human simulations, the addition of a 1.5T magnetic field caused an average dose increase of 49% (range:36%–60%) to lung at the soft tissue-to-lung interface and an average dose decrease of 30% (range:25%–36%) at the lung-to-soft tissue interface. In mouse simulations, the magnetic fields had no effect on the 225kVp dose distribution. The dose increases for the Cs-137 beam were 12%, 33%, and 49% for 0.75T, 1.5T, and 3.0T magnetic fields, respectively while the dose decreases were 7%, 23%, and 33%. For the Co-60 beam, the dose increases were 14%, 45%, and 41%, and the dose decreases were 18%, 35%, and 35%. Conclusion: The magnetic field dose effects observed in mouse phantoms using a Co-60 beam with 1.5T or 3T fields and a Cs-137 beam with a 3T field compare well with those seen in simulated human treatments with an MRI-linac. These irradiator/magnet combinations are suitable for preclinical studies investigating potential biological effects of delivering radiation therapy in the presence of a magnetic field. Partially funded by Elekta.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Dose response of selected solid state detectors in applied homogeneous transverse and longitudinal magnetic fields

Purpose: MR-Linac devices under development worldwide will require standard calibration, commissioning, and quality assurance. Solid state radiation detectors are often used for dose profiles and percent depth dose measurements. The dose response of selected solid state detectors is therefore evaluated in varying transverse and longitudinal magnetic fields for this purpose. Methods: The Monte Carlo code PENELOPE was used to model irradiation of a PTW 60003 diamond detector and IBA PFD diode detector in the presence of a magnetic field. The field itself was varied in strength, and oriented both transversely and longitudinally with respect to the incident photon beam. The long axis of the detectors was oriented either parallel or perpendicular to the photon beam. The dose to the active volume of each detector in air was scored, and its ratio to dose with zero magnetic field strength was determined as the “dose response” in magnetic field. Measurements at low fields for both detectors in transverse magnetic fields were taken to evaluate the accuracy of the simulations. Additional simulations were performed in a water phantom to obtain few representative points for beam profile and percent depth dose measurements. Results: Simulations show significant dose response as a function of magnetic field in transverse field geometries. This response can be near 20% at 1.5 T, and it is highly dependent on the detectors’ relative orientation to the magnetic field, the energy of the photon beam, and detector composition. Measurements at low transverse magnetic fields verify the simulations for both detectors in their relative orientations to radiation beam. Longitudinal magnetic fields, in contrast, show little dose response, rising slowly with magnetic field, and reaching 0.5%–1% at 1.5 T regardless of detector orientation. Water tank and in air simulation results were the same within simulation uncertainty where lateral electronic equilibrium is present and expectedly differed at the beam edge in transverse field orientations only. Due to the difference in design, the two detectors behaved differently. Conclusions: When transverse magnetic fields are present, great care must be taken when using diamond or diode detectors. Dose response varies with relative detector orientation, magnetic field strength, and between detectors. This response can be considerable (∼20% for both detectors). Both detectors in longitudinal fields exhibit little to no dose response as a function of magnetic field. Water tank simulations seem to suggest that the diode detector is better suited to general beam commissioning, and each detector must be investigated separately.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

Validation of a deformable image registration technique for cone beam CT-based dose verification

Purpose: As radiation therapy evolves toward more adaptive techniques, image guidance plays an increasingly important role, not only in patient setup but also in monitoring the delivered dose and adapting the treatment to patient changes. This study aimed to validate a method for evaluation of delivered intensity modulated radiotherapy (IMRT) dose based on multimodal deformable image registration (DIR) for prostate treatments. Methods: A pelvic phantom was scanned with CT and cone-beam computed tomography (CBCT). Both images were digitally deformed using two realistic patient-based deformation fields. The original CT was then registered to the deformed CBCT resulting in a secondary deformed CT. The registration quality was assessed as the ability of the DIR method to recover the artificially induced deformations. The primary and secondary deformed CT images as well as vector fields were compared to evaluate the efficacy of the registration method and it’s suitability to be used for dose calculation. PLASTIMATCH, a free and open source software was used for deformable image registration. A B-spline algorithm with optimized parameters was used to achieve the best registration quality. Geometric image evaluation was performed through voxel-based Hounsfield unit (HU) and vector field comparison. For dosimetric evaluation, IMRT treatment plans were created and optimized on the original CT image and recomputed on the two warped images to be compared. The dose volume histograms were compared for the warped structures that were identical in both warped images. This procedure was repeated for the phantom with full, half full, and empty bladder. Results: The results indicated mean HU differences of up to 120 between registered and ground-truth deformed CT images. However, when the CBCT intensities were calibrated using a region of interest (ROI)-based calibration curve, these differences were reduced by up to 60%. Similarly, the mean differences in average vector field lengths decreased from 10.1 to 2.5 mm when CBCT was calibrated prior to registration. The results showed no dependence on the level of bladder filling. In comparison with the dose calculated on the primary deformed CT, differences in mean dose averaged over all organs were 0.2% and 3.9% for dose calculated on the secondary deformed CT with and without CBCT calibration, respectively, and 0.5% for dose calculated directly on the calibrated CBCT, for the full-bladder scenario. Gamma analysis for the distance to agreement of 2 mm and 2% of prescribed dose indicated a pass rate of 100% for both cases involving calibrated CBCT and on average 86% without CBCT calibration. Conclusions: Using deformable registration on the planning CT images to evaluate the IMRT dose based on daily CBCTs was found feasible. The proposed method will provide an accurate dose distribution using planning CT and pretreatment CBCT data, avoiding the additional uncertainties introduced by CBCT inhomogeneity and artifacts. This is a necessary initial step toward future image-guided adaptive radiotherapy of the prostate.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-C-BRD-04: Comparison of Shallow Fluence to Deep Point Dose Measurements for Spine VMAT SBRT Patient-Specific QA

Purpose: To investigate the sensitivity of traditional gamma-index-based fluence measurements for patient-specific measurements in VMAT delivered spine SBRT. Methods: The ten most recent cases for spine SBRT were selected. All cases were planned with Eclipse RapidArc for a TrueBeam STx. The delivery was verified using a point dose measurement with a Pinpoint 3D micro-ion chamber in a Standard Imaging Stereotactic Dose Verification Phantom. Two points were selected for each case, one within the target in a low dose-gradient region and one in the spinal cord. Measurements were localized using on-board CBCT. Cumulative and separate arc measurements were acquired with the ArcCheck and assessed using the SNC patient software with a 3%/3mm and 2%/2mm gamma analysis with global normalization and a 10% dose threshold. Correlations between data were determined using the Pearson Product-Moment Correlation. Results: For our cohort of patients, the measured doses were higher than calculated ranging from 2.2%–9.7% for the target and 1.0%–8.2% for the spinal cord. There was strong correlation between 3%/3mm and 2%/2mm passing rates (r=0.91). Moderate correlation was found between target and cord dose with a weak fit (r=0.67, R-Square=0.45). The cumulative ArcCheck measurements showed poor correlation with the measured point doses for both the target and cord (r=0.20, r=0.35). If the arcs are assessed separately with an acceptance criteria applied to the minimum passing rate between all arcs, a moderate negative correlation was found for the target and cord (r=−0.48, r= −0.71). The case with the highest dose difference (9.7%) received a passing rate of 97.2% for the cumulative arcs and 87.8% for the minimum with separate arcs. Conclusion: Our data suggest that traditional passing criteria using ArcCheck with cumulative measurements do not correlate well with dose errors. Separate arc analysis shows better correlation but may still miss large dose errors. Point dose verifications are recommended.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-D-BRB-06: Treating Glioblastoma Multiforme (GBM) as a Chronic Disease: Implication of Temporal-Spatial Dose Fractionation Optimization Including Cancer Stem Cell Dynamics

Purpose: To explore the feasibility of improving GBM treatment outcome with temporal-spatial dose optimization of an ordinary differential equation (ODE) that models the differentiation and distinct radiosensitivity between cancer stem cells (CSC) and differentiated cancer cells (DCC). Methods: The ODE was formulated into a non-convex optimization problem with the objective to minimize remaining total cancer cells 500 days from the onset of radiotherapy when the total cancer cell number was 3.5×10{sup 7}, while maintaining normal tissue biological effective dose (BED) of 100Gy resulted from standard prescription of 2Gyx30. Assuming spatially separated CSC and DCC, optimization was also performed to explore the potential benefit from dose-painting the two compartments. Dose escalation to a sub-cell-population in the GTV was also examined assuming that a 2 cm margin around the GTV allows sufficient dose drop-off to 100Gy BED. The recurrence time was determined as the time at which the total cancer cell number regrows to 10{sup 9} cells. Results: The recurrence time with variable fractional doses administered once per week, bi-week and month for one year were found to be 615, 593 and 570 days, superior to the standard-prescription recurrence time of 418 days. The optimal dose-fraction size progression for both uniform and dose-painting to the tumor is low and relatively constant in the beginning and gradually increases to more aggressive fractions at end of the treatment course. Dose escalation to BED of 200Gy to the whole tumor alongside with protracted weekly treatment was found to further delay recurrence to 733 days. Dose-painting of 200 and 500Gy BED to CSC on a year-long weekly schedule further extended recurrence to 736 and 1076 days, respectively. Conclusion: GBM treatment outcome can possibly be improved with a chronic treatment approach. Further dose escalation to the entire tumor or CSC targeted killing is needed to achieve total tumor control. This work is supported by the NSF Graduate Research Fellowship (DGE-1144087)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-I-36: A KWIC and Dirty Look at Dose Savings and Perfusion Metrics in Simulated CT Neuro Perfusion Exams

Purpose: CT neuro perfusion scans are one of the highest dose exams. Methods to reduce dose include decreasing the number of projections acquired per gantry rotation, however conventional reconstruction of such scans leads to sampling artifacts. In this study we investigated a projection view-sharing reconstruction algorithm used in dynamic MRI – “K-space Weighted Image Contrast” (KWIC) – applied to simulated perfusion exams and evaluated dose savings and impacts on perfusion metrics. Methods: A FORBILD head phantom containing simulated time-varying objects was developed and a set of parallel-beam CT projection data was created. The simulated scans were 60 seconds long, 1152 projections per turn, with a rotation time of one second. No noise was simulated. 5mm, 10mm, and 50mm objects were modeled in the brain. A baseline, “full dose” simulation used all projections and reduced dose cases were simulated by downsampling the number of projections per turn from 1152 to 576 (50% dose), 288 (25% dose), and 144 (12.5% dose). KWIC was further evaluated at 72 projections per rotation (6.25%). One image per second was reconstructed using filtered backprojection (FBP) and KWIC. KWIC reconstructions utilized view cores of 36, 72, 144, and 288 views and 16, 8, 4, and 2 subapertures respectively. From the reconstructed images, time-to-peak (TTP), cerebral blood flow (CBF) and the FWHM of the perfusion curve were calculated and compared against reference values from the full-dose FBP data. Results: TTP, CBF, and the FWHM were unaffected by dose reduction (to 12.5%) and reconstruction method, however image quality was improved when using KWIC. Conclusion: This pilot study suggests that KWIC preserves image quality and perfusion metrics when under-sampling projections and that the unique contrast weighting of KWIC could provided substantial dose-savings for perfusion CT scans. Evaluation of KWIC in clinical CT data will be performed in the near future. R01 EB014922, NCI Grant U01 CA181156 (Quantitative Imaging Network), and Tobacco Related Disease Research Project grant 22RT-0131.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-J-87: Ventilation Weighting Effect On Mean Doses of Both Side Lungs for Patients with Advanced Stage Lung Cancer

Purpose: To study ventilation weighting effect on radiation doses to both side lungs for patients with advanced stage lung cancer. Methods: Fourteen patients with advanced stage lung cancer were included in this retrospective study. Proprietary software was developed to calculate the lung ventilation map based on 4DCT images acquired for radiation therapy. Two phases of inhale (0%) and exhale (50%) were used for the lung ventilation calculations. For each patient, the CT images were resampled to the same dose calculation resolution of 3mmx3mmx3mm. The ventilation distribution was then normalized by the mean value of the ventilation. The ventilation weighted dose was calculated by applying linearly weighted ventilation to the dose of each pixel. The lung contours were automatically delineated from patient CT image with lung window, excluding the tumor and high density tissues. For contralateral and ipsilateral lungs, the mean lung doses from the original plan and ventilation weighted mean lung doses were compared using two tail t-Test. Results: The average of mean dose was 6.1 ±3.8Gy for the contralateral lungs, and 26.2 ± 14.0Gy for the ipsilateral lungs. The average of ventilation weighted dose was 6.3± 3.8Gy for the contralateral lungs and 24.6 ± 13.1Gy for the ipsilateral lungs. The statistics analysis shows the significance of the mean dose increase (p<0.015) for the contralateral lungs and decrease (p<0.005) for the ipsilateral lungs. Conclusion: Ventilation weighted doses were greater than the un-weighted doses for contralateral lungs and smaller for ipsilateral lungs. This Result may be helpful to understand the radiation dosimetric effect on the lung function and provide planning guidance for patients with advance stage lung cancer.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-120: Analytic Dose Verification for Patient-Specific Proton Pencil Beam Scanning Plans

Purpose: To independently verify the QA dose of proton pencil beam scanning (PBS) plans using an analytic dose calculation model. Methods: An independent proton dose calculation engine is created using the same commissioning measurements as those employed to build our commercially available treatment planning system (TPS). Each proton PBS plan is exported from the TPS in DICOM format and calculated by this independent dose engine in a standard 40 x 40 x 40 cm water tank. This three-dimensional dose grid is then compared with the QA dose calculated by the commercial TPS, using standard Gamma criterion. A total of 18 measured pristine Bragg peaks, ranging from 100 to 226 MeV, are used in the model. Intermediate proton energies are interpolated. Similarly, optical properties of the spots are measured in air over 15 cm upstream and downstream, and fitted to a second-order polynomial. Multiple Coulomb scattering in water is approximated analytically using Preston and Kohler formula for faster calculation. The effect of range shifters on spot size is modeled with generalized Highland formula. Note that the above formulation approximates multiple Coulomb scattering in water and we therefore chose not use the full Moliere/Hanson form. Results: Initial examination of 3 patient-specific prostate PBS plans shows that agreement exists between 3D dose distributions calculated by the TPS and the independent proton PBS dose calculation engine. Both calculated dose distributions are compared with actual measurements at three different depths per beam and good agreements are again observed. Conclusion: Results here showed that 3D dose distributions calculated by this independent proton PBS dose engine are in good agreement with both TPS calculations and actual measurements. This tool can potentially be used to reduce the amount of different measurement depths required for patient-specific proton PBS QA.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-366: Estimation of Whole Body Dose From Cranial Irradiation From C and Perfexion Series Gamma Knife Units

Purpose: The Leksell Gamma Knife (GK) B & C series contains 201 Cobalt-60 sources with a helmet. The new model, Perfexion uses 192 Cobalt-60 sources without a helmet; using IRIS system for collimation and stereotactic guidance to deliver SRS to brain tumors. Relative dose to extracranial organs at risk (OARs) is measured in phantom in this study for Perfexion and C-series GK. Materials & Methods: Measurements were performed in a Rando anthropomorphic phantom on both systems using a large ion chamber (Keithley-175) for each collimator. The Keithley-175 cc ion chamber was sandwiched between phantom slices at various locations in the phantom to correspond to different extracranial OARs (thyroid, heart, kidney, ovary and testis, etc.) The dose measurement was repeated with OSL detectors for each position and collimator. Results: A large variation is observed in the normalized dose between these two systems. The dose beyond the housing falls off exponentially for Perfexion. Dose beyond the C-series GK housing falls off exponentially from 0–20cm then remains relatively constant from 20–40cm and again falls off with distance but less rapidly. The variation of extracranial dose with distance for each collimator is found to be parallel to each other for both systems. Conclusion: Whole body dose is found to vary significantly between these systems. It is important to measure the extracranial dose, especially for young patients. It is estimated that dose falls off exponentially from the GK housing and is about 1% for large collimators at 75 cm. The dose is two-orders of magnitude smaller for the 4mm collimator. However, this small dose for patient may be significant radiologically.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-559: Monte Carlo Simulation of Cobalt-60 Teletherapy Unit Modeling In-Field and Out-Of-Field Doses for Applications in Computational Radiation Dosimetry

Purpose: Mean organ doses from structures located in field and outside of field boundaries during radiotherapy treatment must be considered when looking at secondary effects. Treatment planning in patients with 40 years of follow-up does not include 3-D treatment planning images and did not estimate dose to structures out of the direct field. Therefore, it is of interest to correlate actual clinical events with doses received. Methods: Accurate models of radiotherapy machines combined with whole body computational phantoms using Monte Carlo methods allow for dose reconstructions intended for studies on late radiation effects. The Theratron-780 radiotherapy unit and anatomically realistic hybrid computational phantoms are modeled in the Monte Carlo radiation transport code MCNPX. The major components of the machine including the source capsule, lead in the unit-head, collimators (fixed/adjustable), and trimmer bars are simulated. The MCNPX transport code is used to compare calculated values in a water phantom with published data from BJR suppl. 25 for in-field doses and experimental data from AAPM Task Group No. 36 for out-of-field doses. Next, the validated cobalt-60 teletherapy model is combined with the UF/NCI Family of Reference Hybrid Computational Phantoms as a methodology for estimating organ doses. Results: The model of Theratron-780 has shown to be agree with percentage depth dose data within approximately 1% and for out of field doses the machine is shown to agree within 8.8%. Organ doses are reported for reference hybrid phantoms. Conclusion: Combining the UF/NCI Family of Reference Hybrid Computational Phantoms along with a validated model of the Theratron-780 allows for organ dose estimates of both in-field and out-of-field organs. By changing field size, position, and adding patient-specific blocking more complicated treatment set-ups can be recreated for patients treated historically, particularly those who lack both 2D/3D image sets.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

SU-E-T-577: Obliquity Factor and Surface Dose in Proton Beam Therapy

Purpose: The advantage of lower skin dose in proton beam may be diminished creating radiation related sequalae usually seen with photon and electron beams. This study evaluates the surface dose as a complex function of beam parameters but more importantly the effect of beam angle. Methods: Surface dose in proton beam depends on the beam energy, source to surface distance, the air gap between snout and surface, field size, material thickness in front of surface, atomic number of the medium, beam angle and type of nozzle (ie double scattering, (DS), uniform scanning (US) or pencil beam scanning (PBS). Obliquity factor (OF) is defined as ratio of surface dose in 0° to beam angle Θ. Measurements were made in water phantom at various beam angles using very small microdiamond that has shown favorable beam characteristics for high, medium and low proton energy. Depth dose measurements were performed in the central axis of the beam in each respective gantry angle. Results: It is observed that surface dose is energy dependent but more predominantly on the SOBP. It is found that as SSD increases, surface dose decreases. In general, SSD, and air gap has limited impact in clinical proton range. High energy has higher surface dose and so the beam angle. The OF rises with beam angle. Compared to OF of 1.0 at 0° beam angle, the value is 1.5, 1.6, 1,7 for small, medium and large range respectively for 60 degree angle. Conclusion: It is advised that just like range and SOBP, surface dose should be clearly understood and a method to reduce the surface dose should be employed. Obliquity factor is a critical parameter that should be accounted in proton beam therapy and a perpendicular beam should be used to reduce surface dose.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

SU-E-T-678: Response Calibration Using Electron Depth-Dose Data for MRI-Based 3D Polymer Gel Dosimetry

Purpose: To evaluate a calibration method using the depth-dose data of an electron beam for MRI-based polymer gel dosimetry. Methods: MAGAT was manufactured in-house to fill two 400mL-cylindrical phantoms and nine 22mL-glass vials. Phantom-A was irradiated along the cylinder axis with a 9MeV electron beam of 6 cm x 6 cm field size (FS). Phantom-B was irradiated with a 6MV photon beam of 3 cm x 3 cm FS by a 360-degree arc technique. Eight vials were irradiated in a water-bath to various doses with a 20 cm x 20 cm FS 6MV photon beam. All irradiated phantoms and one un-irradiated vial were scanned with a 3T MRI scanner to obtain the spin-spin relaxation rate (R2) distributions. By comparing the measured R2-to-depth data with the known depth-dose data for Phantom-A, R2-to-dose calibration data were obtained (e-beam method). Another calibration data were obtained from the 9 vials data (9-vial method). We tested two regression equations, i.e., third-order polynomial and tangent functions, and two dose normalization methods, i.e., one-point and two-point methods. Then, these two calibration methods were used to obtain the 3D dose distribution of Phantom-B and evaluated by comparing the measured data with the dose distribution from a treatment planning system. The comparison was made with gamma passing rate (2%/2mm criteria). Results: We did not observe a clear advantage of the e-beam method over the 9-vial method for the 3D dose comparison with the test case. Nevertheless, we found that the e-beam method required a smaller dose scaling for the dose comparison. Furthermore, the tangent function showed better data fitting than the polynomial function with smaller uncertainty of the estimated coefficients. Conclusions: Considering the overall superior performance, we recommend the e-beam method with the tangent function as the regression equation and one-point dose normalization for the MRI-based polymer gel dosimetry.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

TU-EF-204-07: Add Tube Current Modulation to a Low Dose Simulation Tool for CT Systems

Purpose: We extended the capabilities of a low dose simulation tool to model Tube-Current Modulation (TCM). TCM is widely used in clinical practice to reduce radiation dose in CT scans. We expect the tool to be valuable for various clinical applications (e.g., optimize protocols, compare reconstruction techniques and evaluate TCM methods). Methods: The tube current is input as a function of z location, instead of a fixed value. Starting from the line integrals of a scan, a new Poisson noise realization at a lower dose is generated for each view. To validate the new functionality, we compared simulated scans with real scans in image space. Results: First we assessed noise in the difference between the low-dose simulations and the original high-dose scan. When the simulated tube current is a step function of z location, the noise at each segment matches the noise of 3 separate constant-tube-current-simulations. Secondly, with a phantom that forces TCM, we compared a low-dose simulation with an equivalent real low-dose scan. The mean CT number of the simulated scan and the real low-dose scan were 137.7±0.6 and 137.8±0.5 respectively. Furthermore, with 240 ROIs, the noise of the simulated scan and the real low-dose scan were 24.03±0.45 and 23.99±0.43 respectively, and they were not statistically different (2-sample t-test, p-value=0.28). The facts that the noise reflected the trend of the TCM curve, and that the absolute noise measurements were not statistically different validated the TCM function. Conclusion: We successfully added tube-current modulation functionality in an existing low dose simulation tool. We demonstrated that the noise reflected an input tube-current modulation curve. In addition, we verified that the noise and mean CT number of our simulation agreed with a real low dose scan. The authors are all employees of Philips. Yijun Ding is also supported by NIBIB P41EB002035 and NIBIB R01EB000803.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

TU-EF-204-09: A Preliminary Method of Risk-Informed Optimization of Tube Current Modulation for Dose Reduction in CT

Purpose: X-rays from CT scans can increase cancer risk to patients. Lifetime Attributable Risk of Cancer Incidence for adult patients has been investigated and shown to decrease as patient age. However, a new risk model shows an increasing risk trend for several radiosensitive organs for middle age patients. This study investigates the feasibility of a general method for optimizing tube current modulation (TCM) functions to minimize risk by reducing radiation dose to radiosensitive organs of patients. Methods: Organ-based TCM has been investigated in literature for eye lens dose and breast dose. Adopting the concept in organ-based TCM, this study seeks to find an optimized tube current for minimal total risk to breasts and lungs by reducing dose to these organs. The contributions of each CT view to organ dose are determined through simulations of CT scan view-by-view using a GPU-based fast Monte Carlo code, ARCHER. A Linear Programming problem is established for tube current optimization, with Monte Carlo results as weighting factors at each view. A pre-determined dose is used as upper dose boundary, and tube current of each view is optimized to minimize the total risk. Results: An optimized tube current is found to minimize the total risk of lungs and breasts: compared to fixed current, the risk is reduced by 13%, with breast dose reduced by 38% and lung dose reduced by 7%. The average tube current is maintained during optimization to maintain image quality. In addition, dose to other organs in chest region is slightly affected, with relative change in dose smaller than 10%. Conclusion: Optimized tube current plans can be generated to minimize cancer risk to lungs and breasts while maintaining image quality. In the future, various risk models and greater number of projections per rotation will be simulated on phantoms of different gender and age. National Institutes of Health R01EB015478.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Computational and human observer image quality evaluation of low dose, knowledge-based CT iterative reconstruction

Purpose: Aims in this study are to (1) develop a computational model observer which reliably tracks the detectability of human observers in low dose computed tomography (CT) images reconstructed with knowledge-based iterative reconstruction (IMR™, Philips Healthcare) and filtered back projection (FBP) across a range of independent variables, (2) use the model to evaluate detectability trends across reconstructions and make predictions of human observer detectability, and (3) perform human observer studies based on model predictions to demonstrate applications of the model in CT imaging. Methods: Detectability (d′) was evaluated in phantom studies across a range of conditions. Images were generated using a numerical CT simulator. Trained observers performed 4-alternative forced choice (4-AFC) experiments across dose (1.3, 2.7, 4.0 mGy), pin size (4, 6, 8 mm), contrast (0.3%, 0.5%, 1.0%), and reconstruction (FBP, IMR), at fixed display window. A five-channel Laguerre–Gauss channelized Hotelling observer (CHO) was developed with internal noise added to the decision variable and/or to channel outputs, creating six different internal noise models. Semianalytic internal noise computation was tested against Monte Carlo and used to accelerate internal noise parameter optimization. Model parameters were estimated from all experiments at once using maximum likelihood on the probability correct, P{sub C}. Akaike information criterion (AIC) was used to compare models of different orders. The best model was selected according to AIC and used to predict detectability in blended FBP-IMR images, analyze trends in IMR detectability improvements, and predict dose savings with IMR. Predicted dose savings were compared against 4-AFC study results using physical CT phantom images. Results: Detection in IMR was greater than FBP in all tested conditions. The CHO with internal noise proportional to channel output standard deviations, Model-k4, showed the best trade-off between fit and model complexity according to AIC{sub c}. With parameters fixed, the model reasonably predicted detectability of human observers in blended FBP-IMR images. Semianalytic internal noise computation gave results equivalent to Monte Carlo, greatly speeding parameter estimation. Using Model-k4, the authors found an average detectability improvement of 2.7 ± 0.4 times that of FBP. IMR showed greater improvements in detectability with larger signals and relatively consistent improvements across signal contrast and x-ray dose. In the phantom tested, Model-k4 predicted an 82% dose reduction compared to FBP, verified with physical CT scans at 80% reduced dose. Conclusions: IMR improves detectability over FBP and may enable significant dose reductions. A channelized Hotelling observer with internal noise proportional to channel output standard deviation agreed well with human observers across a wide range of variables, even across reconstructions with drastically different image characteristics. Utility of the model observer was demonstrated by predicting the effect of image processing (blending), analyzing detectability improvements with IMR across dose, size, and contrast, and in guiding real CT scan dose reduction experiments. Such a model observer can be applied in optimizing parameters in advanced iterative reconstruction algorithms as well as guiding dose reduction protocols in physical CT experiments.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-C-206-07: A Practical Sparse View Ultra-Low Dose CT Acquisition Scheme for PET Attenuation Correction in the Extended Scan Field-Of-View

Purpose: To further reduce CT dose, a practical sparse-view acquisition scheme is proposed to provide the same attenuation estimation as higher dose for PET imaging in the extended scan field-of-view. Methods: CT scans are often used for PET attenuation correction and can be acquired at very low CT radiation dose. Low dose techniques often employ low tube voltage/current accompanied with a smooth filter before backprojection to reduce CT image noise. These techniques can introduce bias in the conversion from HU to attenuation values, especially in the extended CT scan field-of-view (FOV). In this work, we propose an ultra-low dose CT technique for PET attenuation correction based on sparse-view acquisition. That is, instead of an acquisition of full amount of views, only a fraction of views are acquired. We tested this technique on a 64-slice GE CT scanner using multiple phantoms. CT scan FOV truncation completion was performed based on the published water-cylinder extrapolation algorithm. A number of continuous views per rotation: 984 (full), 246, 123, 82 and 62 have been tested, corresponding to a CT dose reduction of none, 4x, 8x, 12x and 16x. We also simulated sparse-view acquisition by skipping views from the fully-acquired view data. Results: FBP reconstruction with Q. AC filter on reduced views in the full extended scan field-of-view possesses similar image quality to the reconstruction on acquired full view data. The results showed a further potential for dose reduction compared to the full acquisition, without sacrificing any significant attenuation support to the PET. Conclusion: With the proposed sparse-view method, one can potential achieve at least 2x more CT dose reduction compared to the current Ultra-Low Dose (ULD) PET/CT protocol. A pre-scan based dose modulation scheme can be combined with the above sparse-view approaches, which can even further reduce the CT scan dose during a PET/CT exam.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-D-209-06: Study On the Dose Conversion Coefficients in Pediatric Radiography with the Development of Children Voxel Phantoms

Purpose: Conversion coefficients of organ dose normalized to entrance skin dose (ESD) are widely used to evaluate the organ doses directly using ESD without time-consuming dose measurement, this work aims to investigate the dose conversion coefficients in pediatric chest and abdomen radiography with the development of 5 years and 10 years old children voxel phantoms. Methods: After segmentation of organs and tissues from CT slice images of ATOM tissue-equivalent phantoms, a 5-year-old and a 10-year-old children computational voxel phantoms were developed for Monte Carlo simulation. The organ doses and the entrance skin dose for pediatric chest postero-anterior projection and abdominal antero-posterior projection were simulated at the same time, and then the organ dose conversion coefficients were calculated.To verify the simulated results, dose measurement was carried out with ATOM tissue-equivalent phantoms for 5 year chest radiography. Results: Simulated results and experimental results matched very well with each other, the result differences of all the organs covered in radiation field were below 16% for 5-year-old child in chest projection. I showed that the conversion coefficients of organs covered in the radiation field were much larger than organs out of the field for all the study cases, for example, the conversion coefficients of stomach, liver intestines, and pancreas are larger for abdomen radiography while conversion coefficients of lungs are larger for chest radiography. Conclusion: The voxel children phantoms were helpful to evaluate the radiation doses more accurately and efficiently. Radiation field was the essential factor that affects the organ dose, use reasonably small field should be encouraged for radiation protection. This work was supported by the National Natural Science Foundation of China(11475047)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-14: Dosimetric Impacts of Various Uncertainties in Cervical Cancer HDR Brachytherapy: Are Conventional Point Doses Good Surrogates for 3D Dosimetry?

Purpose: In the context of evaluating dosimetric impacts of a variety of uncertainties involved in HDR Tandem-and-Ovoid treatment, to study the correlations between conventional point doses and 3D volumetric doses. Methods: For 5 cervical cancer patients treated with HDR T&O, 150 plans were retrospectively created to study dosimetric impacts of the following uncertainties: (1) inter-fractional applicator displacement between two treatment fractions within a single insertion by applying Fraction#1 plan to Fraction#2 CT; (2) positional dwell error simulated from −5mm to 5mm in 1mm steps; (3) simulated temporal dwell error of 0.05s, 0.1s, 0.5s, and 1s. The original plans were based on point dose prescription, from which the volume covered by the prescription dose was generated as the pseudo target volume to study the 3D target dose effect. OARs were contoured. The point and volumetric dose errors were calculated by taking the differences between original and simulated plans. The correlations between the point and volumetric dose errors were analyzed. Results: For the most clinically relevant positional dwell uncertainty of 1mm, temporal uncertainty of 0.05s, and inter-fractional applicator displacement within the same insertion, the mean target D90 and V100 deviation were within 1%. Among these uncertainties, the applicator displacement showed the largest potential target coverage impact (2.6% on D90) as well as the OAR dose impact (2.5% and 3.4% on bladder D2cc and rectum D2cc). The Spearman correlation analysis shows a correlation coefficient of 0.43 with a p-value of 0.11 between target D90 coverage and H point dose. Conclusion: With the most clinically relevant positional and temporal dwell uncertainties and patient interfractional applicator displacement within the same insertion, the dose error is within clinical acceptable range. The lack of correlation between H point and 3D volumetric dose errors is a motivator for the use of 3D treatment planning in cervical HDR brachytherapy.

60 APPLIED LIFE SCIENCES↗