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At least 703 records · Page 39
All sourcesNASA NTRSDOE OSTI
DOE OSTI2015

SU-D-304-01: Development of An Applicator for Treating Shallow and Moving Tumors with Respiratory-Gated Spot-Scanning Proton Therapy Using Real-Time Image Guidance

Purpose: To develop a method for treating shallow and moving tumors (e.g., lung tumors) with respiratory-gated spot-scanning proton therapy using real-time image guidance (RTPT). Methods: An applicator was developed which can be installed by hand on the treatment nozzle. The mechanical design was considered such that the Bragg peaks are placed at the patient surface while a sufficient field of view (FOV) of fluoroscopic X-rays was maintained during the proton beam delivery. To reduce the treatment time maintaining the robustness of the dose distribution with respect to motion, a mini-ridge filter (MRF) was sandwiched between two energy absorbers. The measurements were performed to obtain a data for beam modeling and to verify the spot position-invariance of a pencil beam dose distribution. For three lung cancer patients, treatment plans were made with and without the MRF and the effects of the MRF were evaluated. Next, the effect of respiratory motion on the dose distribution was investigated. Results: To scan the proton beam over a 14 x 14 cm area while maintaining the φ16 cm of fluoroscopic FOV, the lower face of the applicator was set 22 cm upstream of the isocenter. With an additional range variance of 2.2 mm and peak-to-peak distance of 4 mm of the MRF, the pencil beam dose distribution was unchanged with the displacement of the spot position. The quality of the treatment plans was not worsened by the MRF. With the MRF, the number of energy layers was reduced to less than half and the treatment time by 26–37%. The simulation study showed that the interplay effect was successfully suppressed by respiratory-gating both with and without MRF. Conclusions: The spot-scanning proton beam was successfully delivered to shallow and moving tumors within a sufficiently short time by installing the developed applicator at the RTPT nozzle.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-D-204-06: Dose and Image Quality Evaluation of a Low-Dose Slot-Scanning X-Ray System for Pediatric Orthopedic Studies

Purpose: Children in early teens with scoliosis require repeated radiographic exams over a number of years. The EOS (EOS imaging S.A., Paris, France) is a novel low-dose slot-scanning digital radiographic system designed to produce full-spine images of a free-standing patient. The radiation dose and image quality characteristics of the EOS were evaluated relative to those of a Computed Radiography (CR) system for scoliosis imaging. Methods: For dose evaluation, a full-torso anthropomorphic phantom was scanned five times using the default standard clinical protocols for both the EOS and a CR system, which include both posteroanterior and lateral full-spine views. Optically stimulated luminescent dosimeters (OSLDs), also known as nanoDots™ (Landauer, Inc., Glenwood, IL), were placed on the phantom’s surface to measure entrance skin dose. To assess image quality, MTF curves were generated from sampling the noise levels within the high-contrast regions of a line-pair phantom. Vertical and horizontal distortions were measured for the square line-pair phantom with the EOS system to evaluate the effects of geometric magnification and misalignment with the indicated imaging plane. Results: The entrance skin dose was measured to be 0.4 to 1.1 mGy for the EOS, and 0.7 to 3.6 mGy for the CR study. MTF comparison shows that CR greatly outperforms the EOS, despite both systems having a limiting resolution at 1.8 line-pairs per mm. Vertical distortion was unaffected by phantom positioning, because of the EOS slot-scanning geometry. Horizontal distortion increased linearly with miscentering distance. Conclusion: The EOS system resulted in approximately 70% lower radiation dose than CR for full-spine images. Image quality was found to be inferior to CR. Further investigation is required to see if EOS system is an acceptable modality for performing clinically diagnostic scoliosis examinations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-J-76: CBCT Reconstruction of a Full Couch Using Rigid Registration and Pre-Scanned Couch Image and Its Clinical Application

Purpose: Only a part of a treatment couch is reconstructed in CBCT due to the limited field of view (FOV). This often generates inaccurate results in the delivered dose evaluation with CBCT and more noise in the CBCT reconstruction. Full reconstruction of the couch at treatment setup can be used for more accurate exit beam dosimetry. The goal of this study is to develop a method to reconstruct a full treatment couch using a pre-scanned couch image and rigid registration. Methods: A full couch (Exact Couch, Varian) model image was reconstructed by rigidly registering and combining two sets of partial CBCT images. The full couch model includes three parts: two side rails and a couch top. A patient CBCT was reconstructed with reconstruction grid size larger than the physical field of view to include the full couch. The image quality of the couch is not good due to data truncation, but good enough to allow rigid registration of the couch. A composite CBCT image of the patient plus couch has been generated from the original reconstruction by replacing couch portion with the pre-acquired model couch, rigidly registered to the original scan. We evaluated the clinical usefulness of this method by comparing treatment plans generated on the original and on the modified scans. Results: The full couch model could be attached to a patient CBCT image set via rigid image registration. Plan DVHs showed 1∼2% difference between plans with and without full couch modeling. Conclusion: The proposed method generated a full treatment couch CBCT model, which can be successfully registered to the original patient image. This method was also shown to be useful in generating more accurate dose distributions, by lowering 1∼2% dose in PTV and a few other critical organs. Part of this study is supported by NIH R01CA133539.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-383: Evaluation of Deep Inspiration Breath-Hold Technique for Post-Mastectomy Proton Pencil Beam Scanning Therapy

Purpose: Deep inspiration breath-hold techniques (DIBH) have been shown to carry significant dosimetric advantages in conventional radiotherapy of left-sided breast cancer. The purpose of this study is to evaluate the use of DIBH techniques for post-mastectomy radiation therapy (PMRT) using proton pencil beam scanning (PBS). Method: Ten PMRT patients, with or without breast implant, underwent two helical CT scans: one with free breathing and the other with deep inspiration breath-hold. A prescription of 50.4 Gy(RBE) to the whole chest wall and lymphatics (axillary, supraclavicular, and intramammary nodes) was considered. PBS plans were generated for each patient’s CT scan using Astroid, an in-house treatment planning system, with the institution conventional clinical PMRT parameters; that is, using a single en-face field with a spot size varying from 8 mm to 14 mm as a function of energy. Similar optimization parameters were used in both plans in order to ensure appropriate comparison. Results: Regardless of the technique (free breathing or DIBH), the generated plans were well within clinical acceptability. DIBH allowed for higher target coverage with better sparing of the cardiac structures. The lung doses were also slightly improved. While the use of DIBH techniques might be of interest, it is technically challenging as it would require a fast PBS delivery, as well as the synchronization of the beam delivery with a gating system, both of which are not currently available at the institution. Conclusion: DIBH techniques display some dosimetric advantages over free breathing treatment for PBS PMRT patients, which warrants further investigation. Plans will also be generated with smaller spot sizes (2.5 mm to 5.5 mm and 5 mm to 9 mm), corresponding to new generation machines, in order to further quantify the dosimetric advantages of DIBH as a function of spot size.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-567: Neutron Dose Equivalent Evaluation for Pencil Beam Scanning Proton Therapy with Apertures

Purpose: To determine the neutron contamination from the aperture in pencil beam scanning during proton therapy. Methods: A Monte Carlo based proton therapy research platform TOPAS and the UF-series hybrid pediatric phantoms were used to perform this study. First, pencil beam scanning (PBS) treatment pediatric plans with average spot size of 10 mm at iso-center were created and optimized for three patients with and without apertures. Then, the plans were imported into TOPAS. A scripting method was developed to automatically replace the patient CT with a whole body phantom positioned according to the original plan iso-center. The neutron dose equivalent was calculated using organ specific quality factors for two phantoms resembling a 4- and 14-years old patient. Results: The neutron dose equivalent generated by the apertures in PBS is 4–10% of the total neutron dose equivalent for organs near the target, while roughly 40% for organs far from the target. Compared to the neutron dose equivalent caused by PBS without aperture, the results show that the neutron dose equivalent with aperture is reduced in the organs near the target, and moderately increased for those organs located further from the target. This is due to the reduction of the proton dose around the edge of the CTV, which causes fewer neutrons generated in the patient. Conclusion: Clinically, for pediatric patients, one might consider adding an aperture to get a more conformal treatment plan if the spot size is too large. This work shows the somewhat surprising fact that adding an aperture for beam scanning for facilities with large spot sizes reduces instead of increases a potential neutron background in regions near target. Changran Geng is supported by the Chinese Scholarship Council (CSC) and the National Natural Science Foundation of China (Grant No. 11475087)

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

SU-E-T-595: Output Factor Calculation for a Uniform Scanning Proton Therapy System

Purpose: To develop an analytical model that predicts dose output factors for patient treatment fields in a uniform scanning proton therapy system. Methods: A model to predict output factors for patient specific treatment fields was produced based on the methods developed by Kooy et al. (2003). The Kooy model predicts the output factor based on the ratio of the entrance dose under calibration conditions to that for a given range and modulation corrected for the inverse square effect. Field specific output factors were plotted as a function of a single parameter r, where r = (Range-Modulation)/Modulation. The model targeted user range 1 sub-span 3 through user range 2 sup-span 2 of the IBA uniform scanning proton therapy system. The data set included points measured using the 10 cm and 18 cm snout sizes to eliminate stem effects on the monitor unit chambers. The data was fit using equation 15 from Kooy et al. (2003), and the resulting model was tested against measurements that were not included in the original data set. Results: For the range and sub span investigated, 120 data points were tested against the model prediction. The model predicted the output factor within 2% for 96% of the points tested and within 2.5% for 99% of the points tested. All points were within 3% of the predicted values. Conclusion: Monitor units for patient treatment fields with proton ranges that fall within the tested interval can be predicted using a model based on the methods developed at MGH. With further evaluation, it will be possible to model all user ranges and sub-spans of the IBA system. Further testing is also needed to predict output factors using a 25 cm snout which introduces variable scanning pattern sizes and stem effects on the monitor unit chambers.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2015

SU-E-T-626: Practical Method to Implement Arc Therapy Using Scanned Particle Beams

Purpose: The purpose of this study was to propose a method to implement arc therapy that is compatible with existing particle therapy systems having gantries and pencil-beam scanning capacities. Furthermore, we sought to demonstrate expected benefits of this method for selected clival chordoma patients. Methods: We propose that a desired particle arc treatment plan can be discretized into a finite number of fixed beams and that only one (or a subset) of these beams be delivered in any single treatment fraction; the target should receive uniform dose during each fraction. For 3 clival-chordoma patients, robust-optimized, scanned proton beams were simulated to deliver 78 Gy (RBE) to clinical target volumes (CTVs), using either a single-field plan with a posterior-anterior (PA) beam or a discrete-arc plan with 16 beams that were equally spaced throughout a 360-degree axial arc. Dose-volume metrics were compared with emphasis on the brainstem, since risk of radiation necrosis there can often restrict application of tumoricidal doses for chordomas. Results: The mean volume of brainstem receiving a dose of 60 Gy (RBE) or higher (V60Gy) was 10.3±0.9 cm{sup 3} for the single-field plan and 4.7±1.8 cm{sup 3} for the discrete-arc plan, a reduction of 55% in favor of arcs. The mean dose to the brainstem was also reduced using arcs, by 18%, while the maximum dose was nearly identical for both methods. For the whole brain, V60Gy was reduced by 23%, in favor of arcs. Mean dose to the CTVs were nearly identical for both strategies, within 0.3%. Conclusion: Discrete arc treatments can be implemented using existing scanned particle-beam facilities. Aside from the physical advantages, the biological uncertainties of particle therapy, particularly high in the distal edge, can be reduced by arc therapy via rotational smearing, which may be of benefit for tumors near the brainstem.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

SU-E-T-778: Use of the 2D MatriXX Detector for Measuring Scanned Ion Beam Parameters

Purpose: The quality assurance (QA) procedure has to check the most relevant beam parameters to ensure the delivery of the correct dose to patients. Film dosimetry, which is commonly used for scanned ion beam QA, does not provide immediate results. The purpose of this work is to answer whether, for scanned ion beam therapy, film dosimetry can be replaced with the 2D MatriXX detector as a real-time tool. Methods: MatriXX, equipped with 32×32 parallel plate ion-chambers, is a commercial device intended for pre-treatment verification of conventional radiation therapy.The MatriXX, placed at the isocenter, and GAFCHROMIC films, positioned on the MatriXX entrance, were exposed to 131.44 MeV proton and 221.45 MeV/u Carbon-ion beams.The OmniPro-I’mRT software, applied for the data taking of MatriXX, gives the possibility of acquiring consecutive snapshots. Using the NI LabVIEW, the data from snapshots were logged as text files for further analysis. Radiochromic films were scanned with EPSON scanner and analyzed using software programs developed in-house for comparative purposes. Results: The field dose uniformity, flatness, beam position and beam width were investigated. The field flatness for the region covering 6×6 cm{sup 2} square field was found to be better than 2%. The relative standard deviations, expected to be constant over 2×2, 4×4 and 6×6 pixels from MatriXX measurement gives a uniformity of 1.5% in good agreement with the film results.The beam center position is determined with a resolution better than 200 µm for Carbon and less than 100 µm for proton beam.The FWHM determination for a beam wider than 10 mm is satisfactory, whilst for smaller beams the determination is uncertain. Conclusion: Precise beam position and fast 2D dose distribution can be determined in real-time using MatriXX detector. The results show that MatriXX is quick and accurate enough to be used in charged-particle therapy QA.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

MO-FG-204-02: Reference Image Selection in the Presence of Multiple Scan Realizations

Purpose: Fusing information from multiple correlated realizations (e.g., 4DCT) can improve image quality. This process often involves ill-conditioned and asymmetric nonlinear registration and the proper selection of a reference image is important. This work proposes to examine post-registration variation indirectly for such selection, and develops further insights to reduce the number of cross-registrations needed. Methods: We consider each individual scan as a noisy point in the vicinity of an image manifold, related by motion. Nonrigid registration “transports” a scan along the manifold to the reference neighborhood, and the residual is a surrogate for local variation. To test this conjecture, 10 thoracic scans from the same session were reconstructed from a recently developed low-dose helical 4DCT protocol. Pairwise registration was repeated bi-directionally (81 times) and fusion was performed with each candidate reference. The fused image quality was assessed with SNR and CNR. Registration residuals in SSD, harmonic energy, and deformation Jacobian behavior were examined. The semi-symmetry is further utilized to reduce the number of registration needed. Results: The comparison of image quality between single image and fused ones identified reduction of local intensity variance as the major contributor of image quality, boosting SNR and CNR by 5 to 7 folds. This observation further suggests the criticality of good agreement across post-registration images. Triangle inequality on the SSD metric provides a proficient upper-bound and surrogate on such disagreement. Empirical observation also confirms that fused images with high residual SSD have lower SNR and CNR than the ones with low or intermediate SSDs. Registration SSD is structurally close enough to symmetry for reduced computation. Conclusion: Registration residual is shown to be a good predictor of post-fusion image quality and can be used to identify good reference centers. Semi-symmetry of the registration residual further reduces computation cost. Supported by in part by NIH R01 CA096679.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

MO-F-CAMPUS-T-04: Utilization of Optical Dosimeter for Modulated Spot-Scanning Particle Beam

Purpose: To present the utilization of an optical dosimeter for modulated spot-scanning carbon-ion and proton beams during the acceptance test of Siemens IONTRIS system. Method and Materials: An optical dosimeter using phosphor scintillation was developed to map and interactively analyze the shapes and sizes of spots over 190 energies for ProTom modulated-scanning system. The dose response to proton had been characterized with proper pixel calibration at ProTom system. The dose response was further studied at 0.7 cm depths by uniform 8cm in-diameter fields of 424.89 MeV/u (E290) carbon-ions and 215.18MeV (E282) protons at IONTRIS system. The virtual source axial distances (vSAD) of carbonions and protons of IONTRIS system was investigated by measuring either variations of spot position or field size at five different locations to Isocenter. By measuring lateral profiles of uniform doses with varied thin-thicknesses of chest-board pattern and placing the scintillation plate at near to the distal edge, range variations at different off-axis-distances (rOAD) were examined. Relative accuracy and reproducibility of beam range were measured for three beam ranges with a ramping block at front of scintillation plate. Results: Similar dose response was observed for high energies of carbon ions and protons. Mean vSAD at X and Y axes were 744.1 cm and 807.4cm with deviation of 7.4cm and 7.7cm, respectively. Variation of rOAD was within 0.35 mm over 10cm for both protons and carbon ions. Accuracy of measuring relative distal range using the ramping block was 0.2mm. Measured range over repeated three times for each range were within 0.25mm at same room, and within 1.0mm between four rooms. Conclusions: The optical dosimeter could efficiently measure the virtual source distance. And, to measure small range variation at different off-axial locations, and for the relative beam range between rooms during acceptance test of a modulated spot-scanning particle system.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

WE-EF-303-08: Proton Radiography Using Pencil Beam Scanning and Novel Micromegas Detectors

Purpose: While the energy of therapeutic proton beams can be adjusted to penetrate to any given depth in water, range uncertainties arise in patients due in part to imprecise knowledge of the stopping power of protons in human tissues. Proton radiography is one approach to reduce the beam range uncertainty, thereby allowing for a reduction in treatment margins and dose escalation. Methods: The authors have adapted a novel detector technology based on Micromesh Gaseous Structure (“Micromegas”) for proton therapy beams and have demonstrated fine spatial and time resolution of magnetically scanned proton pencil beams, as well as wide dynamic range for dosimetry. In this work, proton radiographs were obtained using Micromegas 2D planes positioned downstream of solid water assemblies. The position-sensitive monitor chambers in the IBA proton delivery nozzle provide the beam entrance position. Results: Radiography with Micromegas detectors and actively scanned beams provide spatial resolution of up to 300 µm and water-equivalent thickness (WET) resolution as good as 0.02% (60 µm out of 31 cm total thickness), with the dose delivered to the patient kept below 2 cGy. The spatial resolution as a function of sample rate and number of delivered protons is found to be near the theoretical Cramer-Rao lower bound. Using the CR bound, we argue that the imaging dose could be further lowered to 1 mGy, while still achieving sub-mm spatial resolution, by relatively simple instrumentation upgrades and beam delivery modifications. Conclusion: For proton radiography, high spatial and WET resolution can be achieved, with minimal additional dose to patient, by using magnetically scanned proton pencil beams and Micromegas detectors.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

Dual ring multilayer ionization chamber and theory-based correction technique for scanning proton therapy

Purpose: To develop a multilayer ionization chamber (MLIC) and a correction technique that suppresses differences between the MLIC and water phantom measurements in order to achieve fast and accurate depth dose measurements in pencil beam scanning proton therapy. Methods: The authors distinguish between a calibration procedure and an additional correction: 1—the calibration for variations in the air gap thickness and the electrometer gains is addressed without involving measurements in water; 2—the correction is addressed to suppress the difference between depth dose profiles in water and in the MLIC materials due to the nuclear interaction cross sections by a semiempirical model tuned by using measurements in water. In the correction technique, raw MLIC data are obtained for each energy layer and integrated after multiplying them by the correction factor because the correction factor depends on incident energy. The MLIC described here has been designed especially for pencil beam scanning proton therapy. This MLIC is called a dual ring multilayer ionization chamber (DRMLIC). The shape of the electrodes allows the DRMLIC to measure both the percentage depth dose (PDD) and integrated depth dose (IDD) because ionization electrons are collected from inner and outer air gaps independently. Results: IDDs for which the beam energies were 71.6, 120.6, 159, 180.6, and 221.4 MeV were measured and compared with water phantom results. Furthermore, the measured PDDs along the central axis of the proton field with a nominal field size of 10 × 10 cm{sup 2} were compared. The spread out Bragg peak was 20 cm for fields with a range of 30.6 and 3 cm for fields with a range of 6.9 cm. The IDDs measured with the DRMLIC using the correction technique were consistent with those that of the water phantom; except for the beam energy of 71.6 MeV, all of the points satisfied the 1% dose/1 mm distance to agreement criterion of the gamma index. The 71.6 MeV depth dose profile showed slight differences in the shallow region, but 94.5% of the points satisfied the 1%/1 mm criterion. The 90% ranges, defined at the 90% dose position in distal fall off, were in good agreement with those in the water phantom, and the range differences from the water phantom were less than ±0.3 mm. The PDDs measured with the DRMLIC were also consistent with those that of the water phantom; 97% of the points passed the 1%/1 mm criterion. Conclusions: It was demonstrated that the new correction technique suppresses the difference between the depth dose profiles obtained with the MLIC and those obtained from a water phantom, and a DRMLIC enabling fast measurements of both IDD and PDD was developed. The IDDs and PDDs measured with the DRMLIC and using the correction technique were in good agreement with those that of the water phantom, and it was concluded that the correction technique and DRMLIC are useful for depth dose profile measurements in pencil beam scanning proton therapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-I-37: How Fat Distribution and Table Height Affect Estimates of Patient Size in CT Scanning: A Phantom Study

Purpose: Localizer projection radiographs acquired prior to CT scans are used to estimate patient size, affecting the function of Automatic Tube Current Modulation (ATCM) and hence CTDIvol and SSDE. Due to geometric effects, the projected patient size varies with scanner table height and with the orientation of the localizer (AP versus PA). This study sought to determine if patient size estimates made from localizer scans is affected by variations in fat distribution, specifically when the widest part of the patient is not at the geometric center of the patient. Methods: Lipid gel bolus material was wrapped around an anthropomorphic phantom to simulate two different body mass distributions. The first represented a patient with fairly rigid fat and had a generally oval shape. The second was bell-shaped, representing corpulent patients more susceptible to gravity’s lustful tug. Each phantom configuration was imaged using an AP localizer and then a PA localizer. This was repeated at various scanner table heights. The width of the phantom was measured from the localizer and diagnostic images using in-house software. Results: 1) The projected phantom width varied up to 39% as table height changed.2) At some table heights, the width of the phantom, designed to represent larger patients, exceeded the localizer field of view, resulting in an underestimation of the phantom width.3) The oval-shaped phantom approached a normalized phantom width of 1 at a table height several centimeters lower (AP localizer) or higher (PA localizer) than did the bell-shaped phantom. Conclusion: Accurate estimation of patient size from localizer scans is dependent on patient positioning with respect to scanner isocenter and is limited in large patients. Further, patient size is more accurately measured on projection images if the widest part of the patient, rather than the geometric center of the patient, is positioned at scanner isocenter.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-138: Commissioning and Evaluating Dose Computation Models for a Dedicated Proton Line Scanning Beam Nozzle in Eclipse Treatment Planning System

Purpose: In this study, we present an effective method to derive low dose envelope of the proton in-air spot fluence at beam positions other than the isocenter to reduce amount of measurements required for planning commission. Also, we demonstrate commissioning and validation results of this method to the Eclipse treatment planning system (version 13.0.29) for a Sumitomo dedicated proton line scanning beam nozzle. Methods: The in-air spot profiles at five beam-axis positions (±200, ±100 and 0 mm) were obtained in trigger mode using a MP3 Water tank (PTW-Freiburg) and a pinpoint ionization chamber (model 31014, PTW-Freiburg). Low dose envelope (below 1% of the center dose) of the spot profile at isocenter was obtained by repeated point measurements to minimize dosimetry uncertainty. The double Gaussian (DG) model was used to fit and obtain optimal σ1, σ2 and their corresponding weightings through our in-house MATLAB (Mathworks) program. σ1, σ2 were assumed to expand linearly along the beam axis from a virtual source position calculated by back projecting fitted sigmas from the single Gaussian (SG) model. Absolute doses in water were validated using an Advanced Markus chamber at the depth of 2cm with Pristine Peak (BP) R90d ranging from 5–32 cm for 10×10 cm2 scanned fields. The field size factors were verified with square fields from 2 to 20 cm at 2cm and before BP depth. Results: The absolute dose outputs were found to be within ±3%. For field size factor, the agreement between calculated and measurement were within ±2% at 2cm and ±3% before BP, except for the field size below 2×2 cm2. Conclusion: The double Gaussian model was found to be sufficient for characterizing the Sumitomo dedicated proton line scanning nozzle. With our effective double Gaussian fitting method, we are able to save significant proton beam time with acceptable output accuracy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-156: Monte Carlo Simulation Using TOPAS for Synchrotron Based Proton Discrete Spot Scanning System

Purpose: This study provides an overview of the design and commissioning of the Monte Carlo (MC) model of the spot-scanning proton therapy nozzle and its implementation for the patient plan simulation. Methods: The Hitachi PROBEAT V scanning nozzle was simulated based on vendor specifications using the TOPAS extension of Geant4 code. FLUKA MC simulation was also utilized to provide supporting data for the main simulation. Validation of the MC model was performed using vendor provided data and measurements collected during acceptance/commissioning of the proton therapy machine. Actual patient plans using CT based treatment geometry were simulated and compared to the dose distributions produced by the treatment planning system (Varian Eclipse 13.6), and patient quality assurance measurements. In-house MATLAB scripts are used for converting DICOM data into TOPAS input files. Results: Comparison analysis of integrated depth doses (IDDs), therapeutic ranges (R90), and spot shape/sizes at different distances from the isocenter, indicate good agreement between MC and measurements. R90 agreement is within 0.15 mm across all energy tunes. IDDs and spot shapes/sizes differences are within statistical error of simulation (less than 1.5%). The MC simulated data, validated with physical measurements, were used for the commissioning of the treatment planning system. Patient geometry simulations were conducted based on the Eclipse produced DICOM plans. Conclusion: The treatment nozzle and standard option beam model were implemented in the TOPAS framework to simulate a highly conformal discrete spot-scanning proton beam system.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-184: 3D Range-Modulator for Scanned Particle Therapy: Development, Monte Carlo Simulations and Measurements

Purpose: Active raster scanning in particle therapy results in highly conformal dose distributions. Treatment time, however, is relatively high due to the large number of different iso-energy layers used. By using only one energy and the so called 3D range-modulator irradiation times of a few seconds only can be achieved, thus making delivery of homogeneous dose to moving targets (e.g. lung cancer) more reliable. Methods: A 3D range-modulator consisting of many pins with base area of 2.25 mm2 and different lengths was developed and manufactured with rapid prototyping technique. The form of the 3D range-modulator was optimised for a spherical target volume with 5 cm diameter placed at 25 cm in a water phantom. Monte Carlo simulations using the FLUKA package were carried out to evaluate the modulating effect of the 3D range-modulator and simulate the resulting dose distribution. The fine and complicated contour form of the 3D range-modulator was taken into account by a specially programmed user routine. Additionally FLUKA was extended with the capability of intensity modulated scanning. To verify the simulation results dose measurements were carried out at the Heidelberg Ion Therapy Center (HIT) with a 400.41 MeV 12C beam. Results: The high resolution measurements show that the 3D range-modulator is capable of producing homogeneous 3D conformal dose distributions, simultaneously reducing significantly irradiation time. Measured dose is in very good agreement with the previously conducted FLUKA simulations, where slight differences were traced back to minor manufacturing deviations from the perfect optimised form. Conclusion: Combined with the advantages of very short treatment time the 3D range-modulator could be an alternative to treat small to medium sized tumours (e.g. lung metastasis) with the same conformity as full raster-scanning treatment. Further simulations and measurements of more complex cases will be conducted to investigate the full potential of the 3D range-modulator.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-209: Multicriteria Optimization Algorithm for Intensity Modulated Radiation Therapy Using Pencil Proton Beam Scanning

Purpose: To provide a multicriteria optimization algorithm for intensity modulated radiation therapy using pencil proton beam scanning. Methods: Intensity modulated radiation therapy using pencil proton beam scanning requires efficient optimization algorithms to overcome the uncertainties in the Bragg peaks locations. This work is focused on optimization algorithms that are based on Monte Carlo simulation of the treatment planning and use the weights and the dose volume histogram (DVH) control points to steer toward desired plans. The proton beam treatment planning process based on single objective optimization (representing a weighted sum of multiple objectives) usually leads to time-consuming iterations involving treatment planning team members. We proved a time efficient multicriteria optimization algorithm that is developed to run on NVIDIA GPU (Graphical Processing Units) cluster. The multicriteria optimization algorithm running time benefits from up-sampling of the CT voxel size of the calculations without loss of fidelity. Results: We will present preliminary results of Multicriteria optimization for intensity modulated proton therapy based on DVH control points. The results will show optimization results of a phantom case and a brain tumor case. Conclusion: The multicriteria optimization of the intensity modulated radiation therapy using pencil proton beam scanning provides a novel tool for treatment planning. Work support by a grant from Varian Inc.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-210: The Variable Virtual Source-To-Axis Distance Effect On A Compact Proton Pencil Beam Scanning System

Purpose: We investigate the spot characteristic and dose profiles properties from a compact gantry proton therapy system. This compact design features a dedicated pencil beam scanning nozzle with the scanning magnet located upstream of the final 60 degree bending magnet. Due to the unique beam line design, uncertainty has been raised in the virtual source-to-axis distance (SAD). We investigate its potential clinical impact through measurements and simulation. Methods: A scintillator camera based detector was used to measure spot characteristics and position accuracy. An ion chamber array device was used to measure planar dose profile. Dose profile in-air simulation was performed using in-house built MATLAB program based on additional spot parameters directly from measurements. Spot characteristics such as position and in-air sigma values were used to general simulated 2D elliptical Gaussian spots. The virtual SAD distance changes in the longitudinal direction were also simulated. Planar dose profiles were generated by summation of simulated spots at the isocenter, 15 cm above the isocenter, and 15 cm below the isocenter for evaluation of potential clinical dosimetric impact. Results: We found that the virtual SAD varies depending on the spot location on the longitudinal axis. Measurements have shown that the variable SAD changes from 7 to 12 meters from one end to the other end of the treatment field in the longitudinal direction. The simulation shows that the planer dose profiles differences between the fixed SAD and variable SAD are within 3% from the isocenter profile and the lateral penumbras are within 1 mm difference. Conclusion: Our measurements and simulations show that there are minimum effects on the spot characteristics and dose profiles for this up-stream scanning compact system proton system. Further treatment planning study is needed with the variable virtual SAD accounted for in the planning system to show minimum dosimetric impact.

60 APPLIED LIFE SCIENCES↗