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At least 73 records · Page 4
All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

SU-E-T-525: Dose Volume Histograms (DVH) Analysis and Comparison with ICRU Point Doses in MRI Guided HDR Brachytherapy for Cervical Cancer

Purpose: Brachytherapy plays a crucial role in management of cervix cancer. MRI compatible applicators have made it possible to accurately delineate gross-target-volume(GTV) and organs-at-risk(OAR) volumes, as well as directly plan, optimize and adapt dose-distribution for each insertion. We sought to compare DVH of tumor-coverage and OARs to traditional Point-A, ICRU-38 bladder and rectum point-doses for four different planning-techniques. Methods: MRI based 3D-planning was performed on Nucletron-Oncentra-TPS for 3 selected patients with varying tumor-sizes and anatomy. GTV,high-risk-clinical-target-volume(HR-CTV), intermediate-risk-clinical-target-volume(IR-CTV) and OARs: rectum, bladder, sigmoid-colon, vaginal-mucosa were delineated. Three conventionally used techniques: mg-Radium-equivalent(RaEq),equal-dwell-weights(EDW), Medical-College-of-Wisconsin proposed points-optimization (MCWO) and a manual-graphical-optimization(MGO) volume-coverage based technique were applied for each patient. Prescription was 6Gy delivered to point-A in Conventional techniques (RaEq, EDW, MCWO). For MGO, goal was to achieve 90%-coverage (D90) to HR-CTV with prescription-dose. ICRU point doses for rectum and bladder, point-A doses, DVH-doses for HR-CTV-D90,0.1cc-volume(D0.1),1ccvolume( D1),2cc-volume(D2) were collected for all plans and analyzed . Results: Mean D90 for HR-CTV normalized to MGO were 0.89,0.84,0.9,1.0 for EDW, RaEq, MCWO, MGO respectively. Mean point-A doses were 21.7% higher for MGO. Conventional techniques with Point-A prescriptions under covered HR-CTV-D90 by average of 12% as compared to MGO. Rectum, bladder and sigmoid doses were highest in MGO-plans for ICRU points as well as D0.1,D1 and D2 doses. Among conventional-techniques, rectum and bladder ICRU and DVH doses(0.1,1,2cc) were not significantly different (within 7%).Rectum D0.1 provided good estimation of ICRU-rectum-point doses (within 3.9%),rectum D0.1 were higher from 0.8 to 3.9% while bladder D0.1 overestimated the bladder ICRU point dose up to 43% for conventional-techniques.Bladder-D2 provided a good estimation of ICRU bladder point-doses(within 3.6%) for conventional-techniques. This correlation is not observed for MGO plans perhaps due to steering of isodose line, leading to unpredictable dwell-weighting. Conclusion: MRI based HDR-planning provides accurate delineation of tumor volumes and normal structures, and optimized tumor-coverage can be achieved with acceptable normal-tissue doses. This study showed that for conventional techniques D0.1 rectum dose and D2 bladder dose are good representation of ICRU-reference-point doses.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-F-BRD-14: The Effect of Radiation-Induced Esophageal Swelling On Dose-Volume Histograms

Purpose: Acute esophagitis results in esophageal swelling. Here we evaluate the effect of this response on DVH metrics calculated throughout the course of radiation therapy. Methods: Twenty-nine NSCLC patients were identified who received weekly CT imaging, and varying esophagitis grades (11 grade0 patients, 12 grade2 patients, 6 grade3 patients), using CTCAE scoring criteria. Deformable image registration was used to map the planning esophagus contour to the weekly CT images. Treatment plans were recalculated on each weekly 4DCT and DVH metrics for the esophagus were compared to the delivered treatment plan. DVH metrics were also extracted for esophagus planning-at-risk volumes (PRV) with 1–3mm uniform expansions. Results: The esophagus V50 increased as the treatment progressed by 2.3±0.7cc and 9.0±1.1cc, for the grade 0 and grade 2/3 patients, respectively. The mean esophageal dose (MED) increased by 3.5±0.9Gy, and 8.0±1.1Gy for the grade 0 and grade 2/3 patients, respectively. In some cases where the planned V50 was similar, it remained the same at the end of treatment for grade 0 cases, but increased for higher grade cases. These apparent changes in delivered dose, as expressed by the DVH, are mostly attributed to volume changes in the regions of esophagitis. In addition, portions of the esophagus of some patients moved into highdose regions. The 2mm PRV was able to account for these differences in all but 1 of the 18 G2/3 patients. The 1mm PRV produced the closest DVH metrics calculated from the average weekly plans compared to the true treatment plan. Conclusion: Esophagus radiation response affects DVH parameters throughout treatment, especially patients with high toxicity. This effect must be considered when comparing DVHs calculated using daily IGRT CT images with those from the original planning CT (e.g. for adaptive planning). Adding a margin to the esophagus can account for variation in DVH metrics.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-254: Dose Volume Histogram (DVH) Analysis of Breath Hold Vs Free Breathing Techniques for Esophageal Tumors

Purpose: Lung and heart doses and associated toxicity are of concern in radiotherapy for esophageal cancer. This study evaluates the dosimetry of deep-inspiration-breath-hold (DIBH) technique as compared to freebreathing( FB) using 3D-conformal treatment(3D-CRT) of esophageal cancer. Methods: Eight patients were planned with FB and DIBH CT scans. DIBH scans were acquired using Varian RPM system. FB and DIBH CTs were contoured per RTOG-1010 to create the planning target volume(PTV) as well as organs at risk volumes(OAR). Two sets of gross target volumes(GTV) with 5cm length were contoured for each patient: proximal at the level of the carina and distal at the level of gastroesophageal junction and were enlarged with appropriate margin to generate Clinical Target Volume and PTV. 3D-CRT plans were created on Eclipse planning system for 45Gy to cover 95% of PTV in 25 fractions for both proximal and distal tumors on FB and DIBH scans. For distal tumors celiac nodes were covered electively. DVH parameters for lung and heart OARs were generated and analyzed. Results: All DIBH DVH parameters were normalized to FB plan values. Average of heart-mean and heart-V40 was 0.70 and 0.66 for proximal lesions. For distal lesions ratios were 1.21 and 2.22 respectively. For DIBH total lung volume increased by 2.43 times versus FB scan. Average of lung-mean, V30, V20, V10, V5 are 0.82, 0.92, 0.76, 0.77 and 0.79 for proximal lesions and 1.17,0.66,0.87,0.93 and 1.03 for distal lesions. Heart doses were lower for breath-hold proximal lesions but higher for distal lesions as compared to free-breathing plans. Lung doses were lower for both proximal and distal breath-hold lesions except mean lung dose and V5 for distal lesions. Conclusion: This study showed improvement of OAR doses for esophageal lesions at mid-thoracic level utilizing DIBH vs FB technique but did not show consistent OAR sparing with DIBH for distal lesions.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2016

SU-F-T-340: Direct Editing of Dose Volume Histograms: Algorithms and a Unified Convex Formulation for Treatment Planning with Dose Constraints

Purpose: To develop a procedure for including dose constraints in convex programming-based approaches to treatment planning, and to support dynamic modification of such constraints during planning. Methods: We present a mathematical approach that allows mean dose, maximum dose, minimum dose and dose volume (i.e., percentile) constraints to be appended to any convex formulation of an inverse planning problem. The first three constraint types are convex and readily incorporated. Dose volume constraints are not convex, however, so we introduce a convex restriction that is related to CVaR-based approaches previously proposed in the literature. To compensate for the conservatism of this restriction, we propose a new two-pass algorithm that solves the restricted problem on a first pass and uses this solution to form exact constraints on a second pass. In another variant, we introduce slack variables for each dose constraint to prevent the problem from becoming infeasible when the user specifies an incompatible set of constraints. We implement the proposed methods in Python using the convex programming package cvxpy in conjunction with the open source convex solvers SCS and ECOS. Results: We show, for several cases taken from the clinic, that our proposed method meets specified constraints (often with margin) when they are feasible. Constraints are met exactly when we use the two-pass method, and infeasible constraints are replaced with the nearest feasible constraint when slacks are used. Finally, we introduce ConRad, a Python-embedded free software package for convex radiation therapy planning. ConRad implements the methods described above and offers a simple interface for specifying prescriptions and dose constraints. Conclusion: This work demonstrates the feasibility of using modifiable dose constraints in a convex formulation, making it practical to guide the treatment planning process with interactively specified dose constraints. This work was supported by the Stanford BioX Graduate Fellowship and NIH Grant 5R01CA176553.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2026

SHIVER - Spectroscopy HIstogram Visualizer for Event Reduction

Visualizing data from neutron scattering experiments is the first step in understanding the physics. The program is intended to generate and plot cuts and slices, through the four dimensional single crystal inelastic datasets, measured on direct geometry neutron spectrometers at the Spallation Neutron Source (ARCS, CNCS, HYSPEC, SEQUOIA).

Savici, AndreiT [Oak Ridge National Laboratory (OR↗
DOE OSTI2014

Gamma ray spectroscopy employing divalent europium-doped alkaline earth halides and digital readout for accurate histogramming

A scintillator radiation detector system according to one embodiment includes a scintillator; and a processing device for processing pulse traces corresponding to light pulses from the scintillator, wherein pulse digitization is used to improve energy resolution of the system. A scintillator radiation detector system according to another embodiment includes a processing device for fitting digitized scintillation waveforms to an algorithm based on identifying rise and decay times and performing a direct integration of fit parameters. A method according to yet another embodiment includes processing pulse traces corresponding to light pulses from a scintillator, wherein pulse digitization is used to improve energy resolution of the system. A method in a further embodiment includes fitting digitized scintillation waveforms to an algorithm based on identifying rise and decay times; and performing a direct integration of fit parameters. Additional systems and methods are also presented.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2016

Gamma ray spectroscopy employing divalent europium-doped alkaline earth halides and digital readout for accurate histogramming

According to one embodiment, a scintillator radiation detector system includes a scintillator, and a processing device for processing pulse traces corresponding to light pulses from the scintillator, where the processing device is configured to: process each pulse trace over at least two temporal windows and to use pulse digitization to improve energy resolution of the system. According to another embodiment, a scintillator radiation detector system includes a processing device configured to: fit digitized scintillation waveforms to an algorithm, perform a direct integration of fit parameters, process multiple integration windows for each digitized scintillation waveform to determine a correction factor, and apply the correction factor to each digitized scintillation waveform.

36 MATERIALS SCIENCE↗
DOE OSTI2014

Quantifying cell migration distance as a contributing factor to the development of rectal toxicity after prostate radiotherapy

Purpose: Spatial information is usually neglected in mathematical models of radiation-induced toxicity. In the presence of inhomogeneous dose distributions produced by intensity modulated radiation therapy (IMRT) and volumetric arc therapy, this may be a limitation. We present a model to quantify the spatial characteristics of the dose distribution on the rectum through the quantification of the distribution of distances between dose points on the surface of the rectum in three-dimensions. The method allows us to evaluate the hypothesis that distances between lower and higher dose regions on the rectum influence radiation damage repair due to the migration of normal cells into damaged areas, and consequently, the development of radiation-induced toxicity in patients treated with radiation for prostate cancer. Methods: We present a method to compute distances between dose points on the surface of the rectum in three dimensions (3D) and to generate distance maps representing the distances between specific dose regions on the rectum. We introduce the concept of the distance dose surface histogram (DDSH), which is computed from the distance maps. The DDSH is a 2D histogram of rectum area on a grid defined by pairwise combinations of dose and distance. Each bin in the DDSH quantifies the area of the rectum exposed to a given dose and at a given distance from other another dose region on the rectum. By summing across the columns and rows of the DDSH, we can generate the dose surface histogram (DSH) and distance surface histogram (DiSH) for a particular dose region. The DiSH is a marginal histogram showing the distribution of distances for the dose points in a specific dose region from another region. We computed the DDSH, DiSH, and DSH for 33 patients treated with IMRT for prostate cancer, nine of whom developed late Grade 2 or higher late rectal toxicity. Results: We show how even though the total area of the rectum exposed to a given dose may be the same for different patients, the distribution of distances for points receiving that dose can be different depending on the shape and contiguity of the region(s) containing those dose points. We also show that area of the rectum in the region receiving more than 75 Gy and at a distance of 16 to 22 mm from the 50 Gy isodose line was significantly correlated to the development of toxicity (p = 0.004, two sided t-test). This suggests that examining the distance distribution of points in specific dose regions could provide valuable additional information in predicting the risk of a patient developing radiation-induced rectal toxicity. Conclusions: We present a new method to quantify the spatial distribution of points in a given region relative to other regions on the rectum. The method provides a means to evaluate the hypothesis that distances between lower and higher dose regions on the rectum influence radiation damage repair due to the migration of normal cells into damaged areas, and may be a contributing factor to the development of radiation-induced toxicity in patients treated with radiation for prostate cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

A Bayesian Modeling Approach for Estimation of a Shape-Free Groundwater Age Distribution using Multiple Tracers

The mixing of groundwaters with different ages in aquifers, groundwater age is more appropriately represented by a distribution rather than a scalar number. To infer a groundwater age distribution from environmental tracers, a mathematical form is often assumed for the shape of the distribution and the parameters of the mathematical distribution are estimated using deterministic or stochastic inverse methods. We found that the prescription of the mathematical form limits the exploration of the age distribution to the shapes that can be described by the selected distribution. In this paper, the use of freeform histograms as groundwater age distributions is evaluated. A Bayesian Markov Chain Monte Carlo approach is used to estimate the fraction of groundwater in each histogram bin. This method was able to capture the shape of a hypothetical gamma distribution from the concentrations of four age tracers. The number of bins that can be considered in this approach is limited based on the number of tracers available. The histogram method was also tested on tracer data sets from Holten (The Netherlands; 3 H, 3 He, 85 Kr, 39 Ar) and the La Selva Biological Station (Costa-Rica; SF 6 , CFCs, 3 H, 4 He and 14 C), and compared to a number of mathematical forms. According to standard Bayesian measures of model goodness, the best mathematical distribution performs better than the histogram distributions in terms of the ability to capture the observed tracer data relative to their complexity. Among the histogram distributions, the four bin histogram performs better in most of the cases. The Monte Carlo simulations showed strong correlations in the posterior estimates of bin contributions, indicating that these bins cannot be well constrained using the available age tracers. The fact that mathematical forms overall perform better than the freeform histogram does not undermine the benefit of the freeform approach, especially for the cases where a larger amount of observed data is available and when the real groundwater distribution is more complex than can be represented by simple mathematical forms.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2021

Boundary detection evaluation

Illustrative embodiments are directed to a method and apparatus for evaluating boundary detection in an image. A processed image is received, wherein a detected boundary of an image of an object is identified in the processed image. A Radon transform is applied to the processed image for a plurality of angles to form a processed image histogram corresponding to the detected boundary for each of the plurality of angles. The processed image histogram for each of the plurality of angles and a corresponding ground truth histogram for each of the plurality of angles is normalized to provide a normalized processed image histogram and a normalized ground truth histogram for each of the plurality of angles, wherein the ground truth histogram corresponds to a ground truth boundary of the object for a corresponding angle. An indication of the edges of the normalized processed image histogram for each of the plurality of angles is plotted to form a boundary detection evaluation visualization.

Wantuch, Andrew C.↗
DOE OSTI2024

Boundary detection evaluation

Illustrative embodiments are directed to a method and apparatus for evaluating boundary detection in an image. A processed image is received, wherein a detected boundary of an image of an object is identified in the processed image. A Radon transform is applied to the processed image for a plurality of angles to form a processed image histogram corresponding to the detected boundary for each of the plurality of angles. The processed image histogram for each of the plurality of angles and a corresponding ground truth histogram for each of the plurality of angles is normalized to provide a normalized processed image histogram and a normalized ground truth histogram for each of the plurality of angles, wherein the ground truth histogram corresponds to a ground truth boundary of the object for a corresponding angle. An indication of the edges of the normalized processed image histogram for each of the plurality of angles is plotted to form a boundary detection evaluation visualization.

Wantuch, Andrew C.↗
DOE OSTI2016

GPU Acceleration of Kernel Density Estimators in Monte Carlo Neutron Transport Simulations

Kernel Density Estimators (KDEs) have recently been explored for use in Monte Carlo radiation transport simulations as an alternative to histogram tallies for capturing spatially-resolved quantities such as neutron flux and reaction rates. Histogram tallies suffer from large uncertainties when detailed spatial resolution of the quantity of interest is required; increasing the resolution of the underlying mesh increases the uncertainty in each histogram bin. KDEs obtain estimates of underlying densities on user-defined points, with the uncertainty at those points being independent of the spatial resolution desired since collisions and particle-track segments are allowed to contribute to the score at multiple tally points. Thus, KDEs show potential for obtaining estimates of a smoother spatially-resolved with reduced variance when compared to a histogram. However, this ability that enables KDEs to obtain lower uncertainties per particle history is more computationally expensive than using a traditional histogram bins on a structured mesh. While KDEs are capable of producing lower tally uncertainties compared to histogram binning for a given number of histories, their increased computational cost may make them less efficient. Even so, it is possible to reduce this additional cost by exporting the KDE tally routines onto Graphics Processing Units (GPUs). GPUs are commonly found on high-performance computing machines as a means of increasing performance without adding additional compute nodes. While it is difficult for existing Monte Carlo radiation transport codes to take advantage of GPUs without rewriting large portions of the code, it is possible to leverage GPUs through heterogeneous computing. This work uses a modified version of OpenMC and exports the KDE tally routines onto a GPU to obtain problem-dependent speedups ranging between 1.6 and 5.0 for the problem studied in this paper. While this methodology is applied to KDEs, the same ideas can be applied to other computationally expensive vectorizable portions of Monte Carlo algorithms. (authors)

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗
DOE OSTI2019

Texture analysis of small renal cell carcinomas at MDCT for predicting relevant histologic and protein biomarkers

Purpose: To assess CT texture features of small renal cell carcinomas (≤ 4cm) for association with key pathologic features including protein biomarkers. Methods: Quantitative CT texture analysis (CTTA) of small renal cancers (≤ 4cm) was performed on non-contrast and portal venous phase abdominal MDCT scans with an ROI drawn at the largest cross-sectional diameter of the tumor using commercially available software. Texture parameters including mean pixel attenuation, the standard deviation (SD) of the pixel distribution histogram, entropy, the mean of positive pixels, the skewness (i.e., asymmetry) of the pixel histogram, kurtosis (i.e., peakness) of the pixel histogram, and the percentage of positive pixels were correlated with pathologic data from surgical resection, including histology and nuclear grade, as well as microarray analysis in a subset (n = 40) including Ki67 index, CRP, and neovascularization (CD105/CD31). Results: Portal venous phase images were available in 249 patients (105 women, 144 men; mean age, 56.7 years) with tumors ≤ 4cm (mean, median, range, ± SD; 2.66, 2.60, 0.3–4.0 ± 0.85 cm). CT texture features of standard deviation, mean of the positive pixels, and entropy of the pixel histogram were significantly associated with histologic cell type (clear vs. non-clear; p < 0.001). Entropy and mean of the positive pixels also showed an association with nuclear grade, although not statistically significant. In the microarray analysis subset, kurtosis of the pixel histogram was associated with CD105/CD31 (p = 0.05). SD also showed some association with CD 105 positivity (p = 0.02) and CAIX expression (p = 0.01). Non-contrast CT images were available in 174 patients (72 women, 102 men; mean age, 57.5 years). Although the association with histology was not as strong as on the portal venous phase, in the subset of patients with microarray data, SD was found to correlate with CRP (p = 0.08), kurtosis with CRP (p = 0.004), CD105/CD31 (p = 0.002), and with Ki 67 index (p < 0.001). Conclusion: CT texture features were significantly associated with important histopathologic features in small renal cancers. These non-invasive measures can be performed retrospectively and may provide useful information when determining follow-up and treatment of small renal cancers.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2021

Validation of the TOPAS Monte Carlo toolkit for HDR brachytherapy simulations

The goal of this work is to validate the user-friendly Geant4-based Monte Carlo toolkit TOol for PArticle Simulation (TOPAS) for brachytherapy applications. Brachytherapy simulations performed with TOPAS were systematically compared with published TG-186 reference data. The photon emission energy spectrum, the air-kerma strength, and the dose-rate constant of the model-based dose calculation algorithm (MBDCA)-WG generic Ir-192 source were extracted. For dose calculations, a track-length estimator was implemented. Additionally, the four Joint AAPM/ESTRO/ABG MBDCA-WG test cases were evaluated through histograms of the local and global dose difference volumes. A prostate, a palliative lung, and a breast case were simulated. For each case, the dose ratio map, the histogram of the global dose difference volume, and cumulative dose-volume histograms were calculated. The air-kerma strength was (9.772 ± 0.001) × 10 -8 U Bq -1 (within 0.3% of the reference value). The dose-rate constant was 1.1107 ± 0.0005 cGy h -1 U -1 (within 0.01% of the reference value). For all cases, at least 96.9% of voxels had a local dose difference within [-1%, 1%] and at least 99.9% of voxels had a global dose difference within [-0.1%, 0.1%]. The implemented track-length estimator scorer was more efficient than the default analog dose scorer by a factor of 237. For all clinical cases, at least 97.5% of voxels had a global dose difference within [-1%, 1%]. Dose-volume histograms were consistent with the reference data. TOPAS was validated for high-dose-rate brachytherapy simulations following the TG-186 recommended approach for MBDCAs. Built on top of Geant4, TOPAS provides broad access to a state-of-the-art Monte Carlo code for brachytherapy simulations.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2013

Modeling the dosimetry of organ-at-risk in head and neck IMRT planning: An intertechnique and interinstitutional study

Purpose: To build a statistical model to quantitatively correlate the anatomic features of structures and the corresponding dose-volume histogram (DVH) of head and neck (HN) Tomotherapy (Tomo) plans. To study if the model built upon one intensity modulated radiation therapy (IMRT) technique (such as conventional Linac) can be used to predict anticipated organs-at-risk (OAR) DVH of patients treated with a different IMRT technique (such as Tomo). To study if the model built upon the clinical experience of one institution can be used to aid IMRT planning for another institution. Methods: Forty-four Tomotherapy intensity modulate radiotherapy plans of HN cases (Tomo-IMRT) from Institution A were included in the study. A different patient group of 53 HN fixed gantry IMRT (FG-IMRT) plans was selected from Institution B. The analyzed OARs included the parotid, larynx, spinal cord, brainstem, and submandibular gland. Two major groups of anatomical features were considered: the volumetric information and the spatial information. The volume information includes the volume of target, OAR, and overlapped volume between target and OAR. The spatial information of OARs relative to PTVs was represented by the distance-to-target histogram (DTH). Important anatomical and dosimetric features were extracted from DTH and DVH by principal component analysis. Two regression models, one for Tomotherapy plan and one for IMRT plan, were built independently. The accuracy of intratreatment-modality model prediction was validated by a leave one out cross-validation method. The intertechnique and interinstitution validations were performed by using the FG-IMRT model to predict the OAR dosimetry of Tomo-IMRT plans. The dosimetry of OARs, under the same and different institutional preferences, was analyzed to examine the correlation between the model prediction and planning protocol. Results: Significant patient anatomical factors contributing to OAR dose sparing in HN Tomotherapy plans have been analyzed and identified. For all the OARs, the discrepancies of dose indices between the model predicted values and the actual plan values were within 2.1%. Similar results were obtained from the modeling of FG-IMRT plans. The parotid gland was spared in a comparable fashion during the treatment planning of two institutions. The model based on FG-IMRT plans was found to predict the median dose of the parotid of Tomotherapy plans quite well, with a mean error of 2.6%. Predictions from the FG-IMRT model suggested the median dose of the larynx, median dose of the brainstem and D2 of the brainstem could be reduced by 10.5%, 12.8%, and 20.4%, respectively, in the Tomo-IMRT plans. This was found to be correlated to the institutional differences in OAR constraint settings. Re-planning of six Tomotherapy patients confirmed the potential of optimization improvement predicted by the FG-IMRT model was correct. Conclusions: The authors established a mathematical model to correlate the anatomical features and dosimetric indexes of OARs of HN patients in Tomotherapy plans. The model can be used for the setup of patient-specific OAR dose sparing goals and quality control of planning results. The institutional clinical experience was incorporated into the model which allows the model from one institution to generate a reference plan for another institution, or another IMRT technique.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

TH-E-BRF-09: Gaussian Mixture Model Analysis of Radiation-Induced Parotid-Gland Injury: An Ultrasound Study of Acute and Late Xerostomia in Head-And-Neck Radiotherapy

Purpose: Xerostomia (dry mouth), secondary to parotid-gland injury, is a distressing side-effect in head-and-neck radiotherapy (RT). This study's purpose is to develop a novel ultrasound technique to quantitatively evaluate post-RT parotid-gland injury. Methods: Recent ultrasound studies have shown that healthy parotid glands exhibit homogeneous echotexture, whereas post-RT parotid glands are often heterogeneous, with multiple hypoechoic (inflammation) or hyperechoic (fibrosis) regions. We propose to use a Gaussian mixture model to analyze the ultrasonic echo-histogram of the parotid glands. An IRB-approved clinical study was conducted: (1) control-group: 13 healthy-volunteers, served as the control; (2) acutetoxicity group − 20 patients (mean age: 62.5 ± 8.9 years, follow-up: 2.0±0.8 months); and (3) late-toxicity group − 18 patients (mean age: 60.7 ± 7.3 years, follow-up: 20.1±10.4 months). All patients experienced RTOG grade 1 or 2 salivary-gland toxicity. Each participant underwent an ultrasound scan (10 MHz) of the bilateral parotid glands. An echo-intensity histogram was derived for each parotid and a Gaussian mixture model was used to fit the histogram using expectation maximization (EM) algorithm. The quality of the fitting was evaluated with the R-squared value. Results: (1) Controlgroup: all parotid glands fitted well with one Gaussian component, with a mean intensity of 79.8±4.9 (R-squared>0.96). (2) Acute-toxicity group: 37 of the 40 post-RT parotid glands fitted well with two Gaussian components, with a mean intensity of 42.9±7.4, 73.3±12.2 (R-squared>0.95). (3) Latetoxicity group: 32 of the 36 post-RT parotid fitted well with 3 Gaussian components, with mean intensities of 49.7±7.6, 77.2±8.7, and 118.6±11.8 (R-squared>0.98). Conclusion: RT-associated parotid-gland injury is common in head-and-neck RT, but challenging to assess. This work has demonstrated that the Gaussian mixture model of the echo-histogram could quantify acute and late toxicity of the parotid glands. This study provides meaningful preliminary data from future observational and interventional clinical research.

60 APPLIED LIFE SCIENCES↗