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DOE OSTI2014

SU-E-J-16: A Review of the Magnitude of Patient Imaging Shifts in Relation to Departmental Policy Changes

Purpose: To evaluate how changes in imaging policy affect the magnitude of shifts applied to patients. Methods: In June 2012, the department's imaging policy was altered to require that any shifts derived from imaging throughout the course of treatment shall be considered systematic only after they were validated with two data points that are consistent in the same direction. Multiple additions and clarifications to the imaging policy were implemented throughout the course of the data collection, but they were mostly of administrative nature. Entered shifts were documented in MOSAIQ (Elekta AB) through the localization offset. The MOSAIQ database was queried to identify a possible trend. A total of 25,670 entries were analyzed, including four linear accelerators with a combination of MV planar, kV planar and kV three dimensional imaging. The monthly average of the magnitude of the vector was used. Plan relative offsets were excluded. During the evaluated period of time, one of the satellite facilities acquired and implemented Vision RT (AlignRT Inc). Results: After the new policy was implemented the shifts variance and standard deviation decreased. The decrease is linear with time elapsed. Vision RT implementation at one satellite facility reduced the number of overall shifts, specifically for breast patients. Conclusion: Changes in imaging policy have a significant effect on the magnitude of shifts applied to patients. Using two statistical points before applying a shift as persistent decreased the overall magnitude of the shifts applied to patients.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Thermal and epithermal neutron fluence rate gradient measurements by PADC detectors in LINAC radiotherapy treatments-field

LINAC VARIAN 2100 is where energetic electrons produce Bremsstrahlung radiation, with energies above the nucleon binding energy (E≈5.5MeV). This radiation induce (γ,n) and (e,e’n) reactions mainly in the natural tungsten target material (its total photoneutron cross section is about 4000 mb in a energy range from 9-17 MeV). These reactions may occur also in other components of the system (e.g. multi leaf collimator). During radiation treatment the human body may receive an additional dose inside and outside the treated volume produced by the mentioned nuclear reactions. We measured the neutron density at the treatment table using nuclear track detectors (PADC-NTD). These covered by a boron-converter are employed, including a cadmium filter, to determine the ratio between two groups of neutron energy, i.e. thermal and epithermal. The PADC-NTD detectors were exposed to the radiation field at the iso-center during regular operation of the accelerator. Neutron are determined indirectly by the converting reaction {sup 10}B(n,α){sup 7}Li the emerging charged particle leave their kinetic energy in the PADC forming a latent nuclear track, enlarged by chemical etching (6N, NaOH, 70°C). Track density provides information on the neutron density through calibration coefficient (∼1.6 10{sup 4} neutrons /track) obtained by a californium source. We report the estimation of the thermal and epithermal neutron field and its gradient for photoneutrons produced in radiotherapy treatments with 18 MV linear accelerators. It was obsered that photoneutron production have higher rate at the iso-center.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗
DOE OSTI2014

SU-E-T-580: Comparison of Cervical Carcinoma IMRT Plans From Four Commercial Treatment Planning Systems (TPS)

Purpose: Different treatment planning systems (TPS) use different treatment optimization and leaf sequencing algorithms. This work compares cervical carcinoma IMRT plans optimized with four commercial TPSs to investigate the plan quality in terms of target conformity and delivery efficiency. Methods: Five cervical carcinoma cases were planned with the Corvus, Monaco, Pinnacle and Xio TPSs by experienced planners using appropriate optimization parameters and dose constraints to meet the clinical acceptance criteria. Plans were normalized for at least 95% of PTV to receive the prescription dose (Dp). Dose-volume histograms and isodose distributions were compared. Other quantities such as Dmin(the minimum dose received by 99% of GTV/PTV), Dmax(the maximum dose received by 1% of GTV/PTV), D100, D95, D90, V110%, V105%, V100% (the volume of GTV/PTV receiving 110%, 105%, 100% of Dp), conformity index(CI), homogeneity index (HI), the volume of receiving 40Gy and 50 Gy to rectum (V40,V50) ; the volume of receiving 30Gy and 50 Gy to bladder (V30,V50) were evaluated. Total segments and MUs were also compared. Results: While all plans meet target dose specifications and normal tissue constraints, the maximum GTVCI of Pinnacle plans was up to 0.74 and the minimum of Corvus plans was only 0.21, these four TPSs PTVCI had significant difference. The GTVHI and PTVHI of Pinnacle plans are all very low and show a very good dose distribution. Corvus plans received the higer dose of normal tissue. The Monaco plans require significantly less segments and MUs to deliver than the other plans. Conclusion: To deliver on a Varian linear-accelerator, the Pinnacle plans show a very good dose distribution. Corvus plans received the higer dose of normal tissue. The Monaco plans have faster beam delivery.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Cobalt, Linac, or Other: What Is the Best Solution for Radiation Therapy in Developing Countries?

The international growth of cancer and lack of available treatment is en route to become a global crisis. With >60% of cancer patients needing radiation therapy at some point during their treatment course, the lack of available facilities and treatment programs worldwide is extremely problematic. The number of deaths from treatable cancers is projected to increase to 11.5 million deaths in 2030 because the international population is aging and growing. In this review, we present how best to answer the need for radiation therapy facilities from a technical standpoint. Specifically, we examine whether cobalt teletherapy machines or megavoltage linear accelerator machines are best equipped to handle the multitudes in need of radiation therapy treatment in the developing world.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-T-309: Tangential Modulated Arc Therapy: A Novel Technique for the Treatment of Superficial Disease

Purpose: We propose a new type of treatment that employs a modulated and sliding tangential photon field to provide superior coverage of superficial targets when compared to other commonly employed methods while drastically reducing dose to the underlying sensitive structures often present in these cases. Methods: Modulated treatment plans were formulated for a set of three representative cases. The first was a revised treatment of a scalp sarcoma, while the second was a treatment of a right posterior chest wall sarcoma. For these cases, asymmetric jaw placement, angular limitations, and central isocenter placements were used to force the optimization algorithm into finding solutions with beamlines that were not perpendicular to the body surface. The final case targeted the chest wall of a breast cancer patient, in which standard treatments were compared to the use of modulated fields with multiple isocenters along the chest wall. Results: When compared with unrestricted modulated arcs, the tangential arc scalp treatment reduced the max and mean doses delivered to the brain by 33Gy (from 55 to 22Gy) and 6Gy (from 14Gy to 8Gy), respectively. In the right posterior chest wall case, the V10 in the ipsilateral lung was kept below 5% while retaining a Rx dose (45Gy) target coverage of over 97%. For the breast case, the modulated plan achieved reductions in high dose to the ipsilateral lung and heart by a factor of 2–3 when compared to classic laterally opposed tangents and reduced the V5 by 40% when compared to standard modulated arcs. Conclusion: Tangential modulated arc therapy has outperformed the conventional modalities of treatment for superficial lesions used in our clinic. We hope that with the advent of digitally controlled linear accelerators, we can uncover further benefits of this new technique and extend its applicability to a wider section of the patient population.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-319: The Impact of Radiation Beam Obliquity and Air Gap Thickness On Optically Stimulated Luminescent in Vivo Dosimetry for Radiation Therapy

Purpose: Optically-stimulated luminescent dosimeters (OSLDs) are increasingly utilized for in vivo dosimetry of complex radiation delivery techniques. Measured doses, however, underestimate planned doses for plans that utilize thermoplastic mask immobilization. The purpose of this work was to quantify the effect of beam obliquity and air gap span between the mask and backscatter material, on measured-to-planned OSLD dose agreement. Methods: A previously-used thermoplastic mask was cut, reheated, and flattened to form a 33 by 9 cm{sup 2} stage approximately 2 mm thick. Two OSLDs were placed on the stage on 5 cm of solid water, covered with 50 by 50 by 5 mm{sup 3} square of bolus, and scanned in the CT simulator. Plans were created with 10 by 10 cm{sup 2} open fields using 4, 6, 10, and 15 MV photon beams at 0°, 45°, and 90° incidence. The isocenter was placed between the OSLDs at 5 mm depth. Dose was calculated and averaged for two OSLDs. Artificial air gaps of 3, 5, 10, and 20 mm were introduced in the plan and dose was recalculated for each energy/angle/gap combination. The experimental setup was replicated on a linear accelerator and air gaps were introduced by “bridging” the thermoplastic stage across solid water plastic of varying thickness. Fields were delivered as planned. OSLDs were read 12–15 hours after irradiation. Results: Measured-toplanned percent differences were constant with increasing gap thickness for 0° and 45° beam angles. At 90° and 0 cm gap, planned dose underestimated measured dose by 10–23% for all energies. This discrepancy decreased linearly to 0% with a 20 mm gap. OSLD signal did not decrease more than 6% for any gap span and energy. Conclusion: With the exception of parallel beam incidence, beam obliquity and air gap thickness did not have a substantial effect on measured-to-planned dose agreement.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2021

Initial Feasibility and Clinical Implementation of Daily MR-Guided Adaptive Head and Neck Cancer Radiation Therapy on a 1.5T MR-Linac System: Prospective R-IDEAL 2a/2b Systematic Clinical Evaluation of Technical Innovation

This prospective study is, to our knowledge, the first report of daily adaptive radiation therapy (ART) for head and neck cancer (HNC) using a 1.5T magnetic resonance imaging-linear accelerator (MR-linac) with particular focus on safety and feasibility and dosimetric results of an online rigid registration-based adapt to position (ATP) workflow.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Colloid Rates of Radionuclides in Cooling Water of the 120-GeV Proton Accelerator Facilities at Fermilab - Paper 58

Cooling water systems for high-energy accelerators are typically equipped with a deionizer to keep water pure for accelerator materials and to remove radionuclides for radioactivity control. Although the deionizers are expected to collect the entire radionuclides, more radioactivity than expected remains in the cooling water in typical cooling water operations at J-PARC and the Tsukuba Campus of High Energy Accelerator Research Organization (KEK), Japan. For example, specific activity of {sup 7}Be in the cooling water for magnetic horns at the J-PARC Neutrino Experimental Facility was observed to be comparable to the limit of {sup 7}Be activity for drain (30 Bq/mL) after enough deionization duration. Removing this activity from the cooling water is an important problem that must be solved before the water can be released into the environment. In our previous study, it was found that some radionuclides had weak retention on ion-exchange resins in the cooling water deionizer system for the K2K target and magnetic horns at the 12-GeV proton accelerator in KEK, Japan. Incomplete adsorption in the deionizer was attributed to colloid formation. Therefore, understanding the colloid formation of radionuclides in cooling water is important for understanding the activity remaining in the cooling water. Colloid formation in water under high-intensity radiation fields has been investigated by previous irradiation experiments. Under 120-GeV proton irradiation of Cu foils in water, it was found that the colloid formation rates of Mg, Mn, Co, Ni, and Cu isotopes and those of {sup 7}Be, {sup 24}Na, {sup 42}K, and {sup 43}K were approximately 30% and 1.8-3.9%, respectively. Sc, Cr, and Fe isotopes were missing from the water. In the photon irradiation of water in a Cu tube using Bremsstrahlung from an electron linear accelerator and a {sup 60}Co γ-ray source at Kyoto University Research Reactor Institute, we observed Cu colloid formation in consequence of the corrosion of Cu. It is possible that radionuclides attach to the colloids formed by the corrosion of accelerator materials and pass through the deionizer. To enhance the understanding of the behavior of radionuclides in cooling water in a high-energy accelerator environment, we investigated the colloid formation of radionuclides in cooling waters at the 120-GeV proton accelerator facilities at Fermilab, USA. We have already reported the previous results of specific activities of γemitting radionuclides and {sup 3}H in water samples collected from eight cooling water systems. Following the previous study, this paper is concerned with the measurement of colloid formation rates of radionuclides in cooling waters. (authors)

43 PARTICLE ACCELERATORS↗
DOE OSTI2014

SU-C-17A-07: The Development of An MR Accelerator-Enabled Planning-To-Delivery Technique for Stereotactic Palliative Radiotherapy Treatment of Spinal Metastases

Purpose: To develop an MR accelerator-enabled online planning-todelivery technique for stereotactic palliative radiotherapy treatment of spinal metastases. The technical challenges include; automated stereotactic treatment planning, online MR-based dose calculation and MR guidance during treatment. Methods: Using the CT data of 20 patients previously treated at our institution, a class solution for automated treatment planning for spinal bone metastases was created. For accurate dose simulation right before treatment, we fused geometrically correct online MR data with pretreatment CT data of the target volume (TV). For target tracking during treatment, a dynamic T2-weighted TSE MR sequence was developed. An in house developed GPU based IMRT optimization and dose calculation algorithm was used for fast treatment planning and simulation. An automatically generated treatment plan developed with this treatment planning system was irradiated on a clinical 6 MV linear accelerator and evaluated using a Delta4 dosimeter. Results: The automated treatment planning method yielded clinically viable plans for all patients. The MR-CT fusion based dose calculation accuracy was within 2% as compared to calculations performed with original CT data. The dynamic T2-weighted TSE MR Sequence was able to provide an update of the anatomical location of the TV every 10 seconds. Dose calculation and optimization of the automatically generated treatment plans using only one GPU took on average 8 minutes. The Delta4 measurement of the irradiated plan agreed with the dose calculation with a 3%/3mm gamma pass rate of 86.4%. Conclusions: The development of an MR accelerator-enabled planning-todelivery technique for stereotactic palliative radiotherapy treatment of spinal metastases was presented. Future work will involve developing an intrafraction motion adaptation strategy, MR-only dose calculation, radiotherapy quality-assurance in a magnetic field, and streamlining the entire treatment process on an MR accelerator.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-494: A MOSFET-Based In-Vivo Dosimetry System for MR Image-Guided Radiation Therapy (MR-IGRT)

Purpose: To determine if a MOSFET based in-vivo dosimetry system can be used for patients undergoing MR-IGRT. Methods: Standard and high sensitivity MOSFET detectors were used for in-field and out-of-field measurements respectively. The systems were benchmarked and calibrated against a calibrated ionization chamber on a standard 6 MV linear accelerator, and then on the MR-IGRT system. Known doses were delivered to a water phantom with the MOSFETs placed between the top of the phantom and underneath a layer of bolus and water equivalent plastic, using a 6 MV beam and a {sup 6} {sup 0}Co MR-IGRT beam. The latter was performed with and without real-time MRI-guidance during the beam delivery (MRIGRT). Results: The in-field dosimeter response was linear from 50-500 cGy with little evidence of energy dependence or change in response due to the permanent static magnetic field of the MR-IGRT system. The detector response varied by < 2% between 6 MV and {sup 6} {sup 0}Co without image guided delivery. The out-of-field dosimeter response was linear from 1-50 cGy; however the detectors did display dose rate and energy dependence as the response varied by > 20% depending on distance from isocenter used during calibration. Therefore, to use the dosimeters for out-of-field measurements they must be calibrated out-of-field. Regardless of the detector orientation in the coronal plan, the response of the MOSFETs during MRI-guided delivery increased by 5% due to induced currents from the dynamic magnetic field present with image guidance. During the MRI-guided delivery, some loss in image quality was seen when the MOSFETs were present in the imaging plane. This was mitigated by using a handheld reader without a transmitting wireless receiver. Conclusion: A MOSFET-based in-vivo dosimetry system can be used for patients receiving MR-IGRT; however the change in detector response due to the dynamic magnetic field requires a special calibration.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

MO-F-CAMPUS-T-02: Optimizing Orientations of Hundreds of Intensity-Modulated Beams to Treat Multiple Brain Targets

Purpose: To investigate a new modulated beam orientation optimization (MBOO) approach maximizing treatment planning quality for the state-of-the-art flattening filter free (FFF) beam that has enabled rapid treatments of multiple brain targets. Methods: MBOO selects and optimizes a large number of intensity-modulated beams (400 or more) from all accessible beam angles surrounding a patient’s skull. The optimization algorithm was implemented on a standalone system that interfaced with the 3D Dicom images and structure sets. A standard published data set that consisted of 1 to 12 metastatic brain tumor combinations was selected for MBOO planning. The planning results from various coplanar and non-coplanar configurations via MBOO were then compared with the results obtained from a clinical volume modulated arc therapy (VMAT) delivery system (Truebeam RapidArc, Varian Oncology). Results: When planning a few number of targets (n<4), MBOO produced results equivalent to non-coplanar multi-arc VMAT planning in terms of target volume coverage and normal tissue sparing. For example, the 12-Gy and 4-Gy normal brain volumes for the 3-target plans differed by less than 1 mL ( 3.0 mLvs 3.8 mL; and 35.2 mL vs 36.3 mL, respectively) for MBOO versus VMAT. However, when planning a larger number of targets (n≥4), MBOO significantly reduced the dose to the normal brain as compared to VMAT, though the target volume coverage was equivalent. For example, the 12-Gy and 4-Gy normal brain volumes for the 12-target plans were 10.8 mL vs. 18.0 mL and 217.9 mL vs. 390.0 mL, respectively for the non-coplanar MBOO versus the non-coplanar VMAT treatment plans, yielding a reduction in volume of more than 60% for the case. Conclusion: MBOO is a unique approach for maximizing normal tissue sparing when treating a large number (n≥4) of brain tumors with FFF linear accelerators. Dr Ma and Dr Sahgal are currently on the board of international society of stereotactic radiosurgery. Dr Sahgal has received support for educational presentations from Elekta company.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

A Real-Time Safety and Quality Reporting System: Assessment of Clinical Data and Staff Participation

Purpose: To report on the use of an incident learning system in a radiation oncology clinic, along with a review of staff participation. Methods and Materials: On September 24, 2010, our department initiated an online real-time voluntary reporting system for safety issues, called the Radiation Oncology Quality Reporting System (ROQRS). We reviewed these reports from the program's inception through January 18, 2013 (2 years, 3 months, 25 days) to assess error reports (defined as both near-misses and incidents of inaccurate treatment). Results: During the study interval, there were 60,168 fractions of external beam radiation therapy and 955 brachytherapy procedures. There were 298 entries in the ROQRS system, among which 108 errors were reported. There were 31 patients with near-misses reported and 27 patients with incidents of inaccurate treatment reported. These incidents of inaccurate treatment occurred in 68 total treatment fractions (0.11% of treatments delivered during the study interval). None of these incidents of inaccurate treatment resulted in deviation from the prescription by 5% or more. A solution to the errors was documented in ROQRS in 65% of the cases. Errors occurred as repeated errors in 22% of the cases. A disproportionate number of the incidents of inaccurate treatment were due to improper patient setup at the linear accelerator (P<.001). Physician participation in ROQRS was nonexistent initially, but improved after an education program. Conclusions: Incident learning systems are a useful and practical means of improving safety and quality in patient care.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Cold energy

Deviations in Q for resonant superconducting radio frequency niobium accelerator cavities are generally correlated with resistivity loss mechanisms. Field dependent Qs are not well modeled by these classical loss mechanisms, but rather can represent a form of precision cavity surface thermometry. When the field dependent Q variation shows improvement with increasing B field level the classical treatment of this problem is inadequate. To justify this behavior hydrogen as a ubiquitous impurity in niobium, which creates measurable property changes, even at very low concentrations is typically considered the cause of such anomalous behavior. This maybe the case in some instances, but more importantly any system operating with a highly coherent field with a significant time dependent magnetic component at near 2° K will have the ability to organize the remaining free spins within the London penetration depth to form a coupled energy reservoir in the form of low mass spin waves. The niobium resonant cavities are composed of a single isotope with a large nuclear spin. When the other loss mechanisms are stripped away this may be the gain medium activated by the low level residual magnetic fields. It was found that one resonant cavity heat treatment produced optimum surface properties and then functioned as a MASER extracting energy from the 2° K thermal bath while cooling the cavity walls. The cavity operating in this mode is a simulator of what can take place in the wider but not colder universe using the cosmic microwave background (CMB) as a thermal source. The low mass, long lifetimes, and the scale of the magnetic spin waves on the weakly magnetized interstellar medium allows energy to be stored that is many orders of magnitude colder than the cosmic microwave background. A linear accelerator cavity becomes a tool to explore the properties of the long wave length magnetic spin waves that populate this cold low energy regime.

43 PARTICLE ACCELERATORS↗
DOE OSTI2015

WE-EF-BRD-00: New Developments in Hybrid MR-Treatment: Applications

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Enhancement of radiation cytotoxicity by gold nanoparticles in MCF-7 breast cancer cell lines

Therapy combined with metallic nanoparticles is a new way to treat cancer, in which gold nanoparticles (AuNPs) are injected through intravenous administration and bound to tumor sites. Radiotherapy aims to deliver a high therapeutic dose of ionizing radiation to the tumor without exceeding normal tissue tolerance. The use of AuNPs which is a high-atomic-number (Z) material in radiotherapy will provide a high probability for photon interaction by photoelectric effect. These provide advantages in terms of radiation dose enhancement. The high linear energy transfer and short range of photoelectric interaction products (photoelectrons, characteristic x-rays, Auger electrons) produce localized dose enhancement of the tumor. In this work, breast cancer cell lines (MCF-7) are seeded in the 96-well plate and were treated with 13 nm AuNPs before they were irradiated with 6 MV and 10 MV photon beam from a medical linear accelerator at various radiation doses. To validate the enhanced killing effect, both with and without AuNPs MCF-7 cells is irradiated simultaneously. By comparison, the results show that AuNPs significantly enhance cancer killing.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

WE-EF-BRD-01: Past, Present and Future: MRI-Guided Radiotherapy From 2005 to 2025

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-EF-BRD-02: Battling Maxwell’s Equations: Physics Challenges and Solutions for Hybrid MRI Systems

MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

60 APPLIED LIFE SCIENCES↗