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At least 721 records · Page 40

Observer Evaluation of a Metal Artifact Reduction Algorithm Applied to Head and Neck Cone Beam Computed Tomographic Images

Purpose and Objectives: To quantify, through an observer study, the reduction in metal artifacts on cone beam computed tomographic (CBCT) images using a projection-interpolation algorithm, on images containing metal artifacts from dental fillings and implants in patients treated for head and neck (H&N) cancer. Methods and Materials: An interpolation-substitution algorithm was applied to H&N CBCT images containing metal artifacts from dental fillings and implants. Image quality with respect to metal artifacts was evaluated subjectively and objectively. First, 6 independent radiation oncologists were asked to rank randomly sorted blinded images (before and after metal artifact reduction) using a 5-point rating scale (1 = severe artifacts; 5 = no artifacts). Second, the standard deviation of different regions of interest (ROI) within each image was calculated and compared with the mean rating scores. Results: The interpolation-substitution technique successfully reduced metal artifacts in 70% of the cases. From a total of 60 images from 15 H&N cancer patients undergoing image guided radiation therapy, the mean rating score on the uncorrected images was 2.3 ± 1.1, versus 3.3 ± 1.0 for the corrected images. The mean difference in ranking score between uncorrected and corrected images was 1.0 (95% confidence interval: 0.9-1.2, P<.05). The standard deviation of each ROI significantly decreased after artifact reduction (P<.01). Moreover, a negative correlation between the mean rating score for each image and the standard deviation of the oral cavity and bilateral cheeks was observed. Conclusion: The interpolation-substitution algorithm is efficient and effective for reducing metal artifacts caused by dental fillings and implants on CBCT images, as demonstrated by the statistically significant increase in observer image quality ranking and by the decrease in ROI standard deviation between uncorrected and corrected images.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Single-cone finite difference scheme for the (2+1)D Dirac von Neumann equation

An explicit finite difference scheme is presented for the von Neumann equation for (2+1)D Dirac fermions. It is founded upon a staggered space–time grid which ensures a single-cone energy dispersion and performs the time-derivative in one sweep using a three-step leap-frog procedure. It enables a space–time-resolved numerical treatment of the mixed-state dynamics of Dirac fermions within the effective single-particle density matrix formalism. Energy-momentum dispersion, stability and convergence properties are derived. Elementary numerical tests to demonstrate stability properties use parameters which pertain to topological insulator surface states. A method for the simulation of charge injection from an electric contact is presented and tested numerically. Potential extensions of the scheme to a Dirac–Lindblad equation, real-space–time Green's function formulations, and higher-order finite-difference schemes are discussed.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗

Cone Beam Computed Tomography: The Challenges and Strategies in Its Application for Dose Accumulation

Online image guidance using cone beam computed tomography (CBCT) has greatly improved the geometric precision of radiotherapy. Changes in anatomy are common during a course of fractionated treatment, resulting in dose deviation from the planned distribution. There is increased interest in performing dose accumulation to compute the actual delivered dose and to adapt the treatment when necessary. This can be achieved by delineating the volume of interest and by generating “dose of the day” through dose computation on the CBCT. However, the image quality and the accuracy of the CT number of CBCT are deemed to be inferior to fan beam CT, which increases the uncertainty associated in this process. A review of literature was conducted to assess the reliability of and to examine strategies for overcoming the challenges in using CBCT for volume delineation and dose computation. The review demonstrates that the uncertainty varies across body sites, and different strategies have been recommended to generate comparable results to images from CT simulators. This facilitates a better understanding of the potential and the limitation of using CBCT for dose accumulation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A Comparison Between Electronic Portal Imaging Device and Cone Beam CT in Radiotherapy Verification of Nasopharyngeal Carcinoma

The demand of greater accuracy in intensity-modulated radiotherapy (IMRT) has driven the development of more advanced verification systems. The purpose of this study is to investigate the differences in verification accuracy in terms of the position error detected between cone-beam computed tomography (CBCT) and electronic portal imaging device (EPID) in the IMRT of nasopharyngeal carcinoma (NPC). Two groups of NPC patients (n = 22 and n = 28) verified by CBCT (G1-CB), EPID (G1-EP), and EPID (G2-EP) only, respectively, were recruited. The positional errors between the G1-CB group and the G2-EP group were compared. In addition, the magnitudes of the position errors of EPID taken in the same session of the CBCT, but after necessary corrections (G1-EP), were analyzed. In the CBCT group, 455 CBCT images (G1-CB) and 206 EPID images (G1-EP) were collected, whereas 319 EPID images (G2-EP) for the EPID group, were recorded. The median position errors detected in CBCT were between 0.80 and 0.90 mm in the antero-posterior (A-P), left-right (L-R), and supero-inferior (S-I) directions, whereas those of the EPID were all 0.50 mm. The magnitude of position deviation detected by the CBCT was higher than that of the EPID and their differences were extremely significant (p < 0.001). The frequencies in the G2-EP group with position errors greater than the tolerance (2 mm) were 32, 42, and 27 in the A-P, L-R, and S-I directions, respectively, which accounted for 16.5%, 21.6%, and 13.9% of the total number of EPID. There was difference in verification capability between the CBCT and EPID when applied to IMRT of NPC patients. Because an average of 1 of 6 verifications in EPID was inferior to that of the CBCT, verification by CBCT is recommended.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Dosimetric Evaluation Between Megavoltage Cone-Beam Computed Tomography and Body Mass Index for Intracranial, Thoracic, and Pelvic Localization

The aim of this study was to evaluate radiation dose for organs at risk (OAR) within the cranium, thorax, and pelvis from megavoltage cone-beam computed tomography (MV-CBCT). Using a clinical treatment planning system, CBCT doses were calculated from 60 patient datasets using 27.4 x 27.4 cm{sup 2} field size and 200{sup o} arc length. The body mass indices (BMIs) for these patients range from 17.2-48.4 kg/m{sup 2}. A total of 60 CBCT plans were created and calculated with heterogeneity corrections, with monitor units (MU) that varied from 8, 4, and 2 MU per plan. The isocenters of these plans were placed at defined anatomical structures. The maximum dose, dose to the isocenter, and mean dose to the selected critical organs were analyzed. The study found that maximum and isocenter doses were weakly associated with BMI, but linearly associated with the total MU. Average maximum/isocenter doses in the cranium were 10.0 ({+-} 0.18)/7.0 ({+-} 0.08) cGy, 5.0 ({+-} 0.09)/3.5 ({+-} 0.05) cGy, and 2.5 ({+-} .04)/1.8 ({+-} 0.05) cGy for 8, 4, and 2 MU, respectively. Similar trends but slightly larger maximum/isocenter doses were found in the thoracic and pelvic regions. For the cranial region, the average mean doses with a total of 8 MU to the eye, lens, and brain were 9.7 ({+-} 0.12) cGy, 9.1 ({+-} 0.16) cGy, and 7.2 ({+-} 0.10) cGy, respectively. For the thoracic region, the average mean doses to the lung, heart, and spinal cord were 6.6 ({+-} 0.05) cGy, 6.9 ({+-} 1.2) cGy, and 4.7 ({+-} 0.8) cGy, respectively. For the pelvic region, the average mean dose to the femoral heads was 6.4 ({+-} 1.1) cGy. The MV-CBCT doses were linearly associated with the total MU but weakly dependent on patients' BMIs. Daily MV-CBCT has a cumulative effect on the total body dose and critical organs, which should be carefully considered for clinical impacts.

61 RADIATION PROTECTION AND DOSIMETRY↗

Experimental evaluation of actual delivered dose using mega-voltage cone-beam CT and direct point dose measurement

Radiation therapy in patients is planned by using computed tomography (CT) images acquired before start of the treatment course. Here, tumor shrinkage or weight loss or both, which are common during the treatment course for patients with head-and-neck (H and N) cancer, causes unexpected differences from the plan, as well as dose uncertainty with the daily positional error of patients. For accurate clinical evaluation, it is essential to identify these anatomical changes and daily positional errors, as well as consequent dosimetric changes. To evaluate the actual delivered dose, the authors proposed direct dose measurement and dose calculation with mega-voltage cone-beam CT (MVCBCT). The purpose of the present study was to experimentally evaluate dose calculation by MVCBCT. Furthermore, actual delivered dose was evaluated directly with accurate phantom setup. Because MVCBCT has CT-number variation, even when the analyzed object has a uniform density, a specific and simple CT-number correction method was developed and applied for the H and N site of a RANDO phantom. Dose distributions were calculated with the corrected MVCBCT images of a cylindrical polymethyl methacrylate phantom. Treatment processes from planning to beam delivery were performed for the H and N site of the RANDO phantom. The image-guided radiation therapy procedure was utilized for the phantom setup to improve measurement reliability. The calculated dose in the RANDO phantom was compared to the measured dose obtained by metal-oxide-semiconductor field-effect transistor detectors. In the polymethyl methacrylate phantom, the calculated and measured doses agreed within about +3%. In the RANDO phantom, the dose difference was less than +5%. The calculated dose based on simulation-CT agreed with the measured dose within±3%, even in the region with a high dose gradient. The actual delivered dose was successfully determined by dose calculation with MVCBCT, and the point dose measurement with the image-guided radiation therapy procedure.

61 RADIATION PROTECTION AND DOSIMETRY↗

A study on planning organ at risk volume for the rectum using cone beam computed tomography in the treatment of prostate cancer

In this study, we analyzed planning organ at risk volume (PRV) for the rectum using a series of cone beam computed tomographies (CBCTs) acquired during the treatment of prostate cancer and evaluated the dosimetric effect of different PRV definitions. Overall, 21 patients with prostate cancer were treated radically with 78 Gy in 39 fractions had in total 418 CBCTs, each acquired at the end of the first 5 fractions and then every alternate fraction. The PRV was generated from the Boolean sum volume of the rectum obtained from first 5 fractions (PRV-CBCT-5) and from all CBCTs (PRV-CBCT-All). The PRV margin was compared at the superior, middle, and inferior slices of the contoured rectum to compare PRV-CBCT-5 and PRV-CBCT-All. We also compared the dose received by the planned rectum (Rectum-computed tomography [CT]), PRV-CBCT-5, PRV-CBCT-All, and average rectum (CBCT-AV-dose-volume histogram [DVH]) at critical dose levels. The average measured rectal volume for all 21 patients for Rectum-CT, PRV-CBCT-5, and PRV-CBCT-All was 44.3 ± 15.0, 92.8 ± 40.40, and 121.5 ± 36.7 cm{sup 3}, respectively. For PRV-CBCT-All, the mean ± standard deviation displacement in the anterior, posterior, right, and left lateral directions in centimeters was 2.1 ± 1.1, 0.9 ± 0.5, 0.9 ± 0.8, and 1.1 ± 0.7 for the superior rectum; 0.8 ± 0.5, 1.1 ± 0.5, 1.0 ± 0.5, and 1.0 ± 0.5 for the middle rectum; and 0.3 ± 0.3; 0.9 ± 0.5; 0.4 ± 0.2, and 0.5 ± 0.3 for the inferior rectum, respectively. The first 5 CBCTs did not predict the PRV for individual patients. Our study shows that the PRV margin is different for superior, middle, and the inferior parts of the rectum, it is wider superiorly and narrower inferiorly. A uniform PRV margin does not represent the actual rectal variations during treatment for all treatment fractions. The large variation in interpatient rectal size implies a potential role for adaptive radiotherapy for prostate cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Kilovoltage cone-beam CT imaging dose during breast radiotherapy: A dose comparison between a left and right breast setup

The purpose of this study was to investigate the delivered dose from a kilovoltage cone-beam computed tomography (kV-CBCT) acquired in breast treatment position for a left and right breast setup. The dose was measured with thermoluminescent dosimeters positioned within a female anthropomorphic phantom at organ locations. Imaging was performed on an Elekta Synergy XVI system with the phantom setup on a breast board. The image protocol involved 120 kVp, 140 mAs, and a 270° arc rotation clockwise 0° to 270° for the left breast setup and 270° to 180° for the right breast setup (maximum arc rotations possible). The dose delivered to the left breast, right breast, and heart was 5.1 mGy, 3.9 mGy, and 4.0 mGy for the left breast setup kV-CBCT, and 6.4 mGy, 6.0 mGy, and 4.8 mGy for the right breast setup kV-CBCT, respectively. The rotation arc of the kV-CBCT influenced the dose delivered, with the right breast setup kV-CBCT found to deliver a dose of up to 4 mGy or 105% higher to the treated breast′s surface in comparison with the left breast setup. This is attributed to the kV-CBCT source being more proximal to the anterior of the phantom for a right breast setup, whereas the source is more proximal to the posterior of the patient for a left-side scan.

61 RADIATION PROTECTION AND DOSIMETRY↗

Fractionated changes in prostate cancer radiotherapy using cone-beam computed tomography

The high mobility of the bladder and the rectum causes uncertainty in radiation doses prescribed to patients with prostate cancer who undergo radiotherapy (RT) multifraction treatments. The purpose of this study was to estimate the dose received by the bladder, rectum, and prostate from multifraction treatments using daily cone-beam computed tomography (CBCT). Overall, 28 patients with prostate cancer who planned to receive radiation treatments were enrolled in the study. The acquired CBCT before the treatment delivery was registered with the planning CT to map the dose distribution used in the treatment plan for estimating the received dose during clinical treatment. For all 28 patients with 112 data sets, the mean percentage differences (± standard deviation) in the volume and radiation dose were 44% (± 41) and 18% (± 17) for the bladder, 20% (± 21) and 2% (± 2) for the prostate, and 36% (± 29) and 22% (± 15) for the rectum, respectively. Substantial differences between the volumes and radiation dose and those specified in treatment plans were observed. Besides the use of image-guided RT to improve patient setup accuracy, further consideration of large changes in bladder and rectum volumes is strongly suggested when using external beam radiation for prostate cancer.

61 RADIATION PROTECTION AND DOSIMETRY↗

A comparison between radiation therapists and medical specialists in the use of kilovoltage cone-beam computed tomography scans for potential lung cancer radiotherapy target verification and adaptation

Target volume matching using cone-beam computed tomography (CBCT) is the preferred treatment verification method for lung cancer in many centers. However, radiation therapists (RTs) are trained in bony matching and not soft tissue matching. The purpose of this study was to determine whether RTs were equivalent to radiation oncologists (ROs) and radiologists (RDs) in alignment of the treatment CBCT with the gross tumor volume (GTV) defined at planning and in delineating the GTV on the treatment CBCT, as may be necessary for adaptive radiotherapy. In this study, 10 RTs, 1 RO, and 1 RD performed a manual tumor alignment and correction of the planning GTV to a treatment CBCT to generate an isocenter correction distance for 15 patient data sets. Participants also contoured the GTV on the same data sets. The isocenter correction distance and the contoured GTVs from the RTs were compared with the RD and RO. The mean difference in isocenter correction distances was 0.40 cm between the RO and RD, 0.51 cm between the RTs, and RO and 0.42 cm between the RTs and RD. The 95% CIs were smaller than the equivalence limit of 0.5 cm, indicating that the RTs were equivalent to the RO and RD. For GTV delineation comparisons, the RTs were not found to be equivalent to the RD or RO. The alignment of the planning defined GTV and treatment CBCT using soft tissue matching by the RTs has been shown to be equivalent to those by the RO and RD. However, tumor delineation by the RTs on the treatment CBCT was not equivalent to that of the RO and RD. Thus, it may be appropriate for RTs to undertake soft tissue alignment based on CBCT; however, further investigation may be necessary before RTs undertake delineation for adaptive radiotherapy purposes.

61 RADIATION PROTECTION AND DOSIMETRY↗

Evaluation of the setup margins for cone beam computed tomography–guided cranial radiosurgery: A phantom study

The aim of this study is to evaluate the setup margins from the clinical target volume (CTV) to planning target volume (PTV) for cranial stereotactic radiosurgery (SRS) treatments guided by cone beam computed tomography (CBCT). We designed an end-to-end (E2E) test using a skull phantom with an embedded 6mm tungsten ball (target). A noncoplanar plan was computed (E2E plan) to irradiate the target. The CBCT-guided positioning of the skull phantom on the linac was performed. Megavoltage portal images were acquired after 15 independent deliveries of the E2E plan. The displacement 2-dimensional (2D) vector between the centers of the square field and the ball target on each portal image was used to quantify the isocenter accuracy. Geometrical margins on each patient's direction (left-right or LR, anterior-posterior or AP, superior-inferior or SI) were calculated. Dosimetric validation of the margins was performed in 5 real SRS cases: 3-dimesional (3D) isocenter deviations were mimicked, and changes in CTV dose coverage and organs-at-risk (OARs) dosage were analyzed. The CTV-PTV margins of 1.1 mm in LR direction, and 0.7 mm in AP and SI directions were derived from the E2E tests. The dosimetric analysis revealed that a 1-mm uniform margin was sufficient to ensure the CTV dose coverage, without compromising the OAR dose tolerances. The effect of isocenter uncertainty has been estimated to be 1 mm in our CBCT-guided SRS approach.

61 RADIATION PROTECTION AND DOSIMETRY↗

A review of setup error in supine breast radiotherapy using cone-beam computed tomography

Setup error in breast radiotherapy (RT) measured with 3-dimensional cone-beam computed tomography (CBCT) is becoming more common. The purpose of this study is to review the literature relating to the magnitude of setup error in breast RT measured with CBCT. The different methods of image registration between CBCT and planning computed tomography (CT) scan were also explored. A literature search, not limited by date, was conducted using Medline and Google Scholar with the following key words: breast cancer, RT, setup error, and CBCT. This review includes studies that reported on systematic and random errors, and the methods used when registering CBCT scans with planning CT scan. A total of 11 relevant studies were identified for inclusion in this review. The average magnitude of error is generally less than 5 mm across a number of studies reviewed. The common registration methods used when registering CBCT scans with planning CT scan are based on bony anatomy, soft tissue, and surgical clips. No clear relationships between the setup errors detected and methods of registration were observed from this review. Further studies are needed to assess the benefit of CBCT over electronic portal image, as CBCT remains unproven to be of wide benefit in breast RT.

61 RADIATION PROTECTION AND DOSIMETRY↗

Jet cone radius dependence of R AA and v 2 at PbPb 5.02 TeV from JEWEL+T R ENTo+v-USPhydro

We combine, for the first time, event-by-event T R ENTo initial conditions with the relativistic viscous hydrodynamic model v-USPhydro and the Monte Carlo event generator JEWEL to make predictions for the nuclear modification factor R AA and jet azimuthal anisotropies v n { 2 } in $\sqrt{s_{NN}}$ = 5.02 TeV PbPb collisions for multiple centralities and values of the jet cone radius R. The R-dependence of R AA and v 2 { 2 } strongly depends on the presence of recoiling scattering centers. We find a small jet v 3 { 2 } in mid-central collisions and consistent results in wide jet p T regions and centralities with ATLAS data.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Near-continuum, hypersonic oxygen flow over a double cone simulated by direct simulation Monte Carlo informed from quantum chemistry

A large-scale, fully resolved direct simulation Monte Carlo (DSMC) computation of a non-equilibrium, reactive flow of pure oxygen over a double cone is presented. Under the simulated near-continuum conditions, the computational demands are shown to be significant because of the wide range of length scales that must be resolved. Therefore, robust grid adaption capabilities and efficient parallelization of the Stochastic PArallel Rarefied-gas Time-accurate Analyzer (SPARTA) code that is utilized in this work are essential. The thermochemical and transport collision models were selected for efficiency and simplicity. First-principles data, obtained from the highly accurate direct molecular simulation method, were used to inform the collision models’ parameters. Importantly, because SPARTA implements molecular collision models using collision-specific energies, the resulting macroscopic relaxation rates were evaluated a posteriori via zero-dimensional heat bath simulations. The comparisons of surface properties, namely heat flux and pressure, show very close agreement with previous computational fluid dynamics (CFD) results. Differences with the measurements were found to be similar to the CFD simulations. The unresolved discrepancy with the measurements could be due to inconsistent free stream conditions with the actual experimental data or missing physical phenomena altogether, for example atomic and molecular oxygen electronically excited states, three-dimensional effects, or more complex gas–surface interactions. As shown in this work, the advantages of obtaining a DSMC particle solution for these flows reside in the method's ability to be directly informed from first principles and to seamlessly describe internal energy non-equilibrium for all modes. With the advent of exascale computing and beyond, particle methods will be an increasingly important tool to verify the validity of physical assumptions in reduced-order models via fully resolved, experimental-scale simulations, down to the level of molecular-level distributions.

Mechanics↗

Drift-cyclotron loss-cone instability in 3-D simulations of a sloshing-ion simple mirror

The kinetic stability of collisionless, sloshing beam-ion (45° pitch angle) plasma is studied in a three-dimensional (3-D) simple magnetic mirror, mimicking the Wisconsin high-temperature superconductor axisymmetric mirror experiment. The collisional Fokker–Planck code CQL3D-m provides a slowing-down beam-ion distribution to initialize the kinetic-ion/fluid-electron code Hybrid-VPIC, which then simulates free plasma decay without external heating or fuelling. Over 1 – 10 μs, drift-cyclotron loss-cone (DCLC) modes grow and saturate in amplitude. The DCLC scatters ions to a marginally stable distribution with gas-dynamic rather than classical-mirror confinement. Sloshing ions can trap cool (low-energy) ions in an electrostatic potential well to stabilize DCLC, but DCLC itself does not scatter sloshing beam-ions into the said well. Instead, cool ions must come from external sources such as charge-exchange collisions with a low-density neutral population. Manually adding cool ∼1keV ions improves beam-ion confinement several-fold in Hybrid-VPIC simulations, which qualitatively corroborates prior measurements from real mirror devices with sloshing ions.

70 PLASMA PHYSICS AND FUSION TECHNOLOGY↗

Giant magnetoelectric effects achieved by tuning spin cone symmetry in Y-type hexaferrites

Multiferroics materials, which exhibit coupled magnetic and ferroelectric properties, have attracted tremendous research interest because of their potential in constructing next-generation multifunctional devices. The application of single-phase multiferroics is currently limited by their usually small magnetoelectric effects. Here, we report the realization of giant magnetoelectric effects in a Y-type hexaferrite Ba 0.4 Sr 1.6 Mg 2 Fe 12 O 22 single crystal, which exhibits record-breaking direct and converse magnetoelectric coefficients and a large electric-field-reversed magnetization. We have uncovered the origin of the giant magnetoelectric effects by a systematic study in the Ba 2-x Sr x Mg 2 Fe 12 O 22 family with magnetization, ferroelectricity and neutron diffraction measurements. With the transverse spin cone symmetry restricted to be two-fold, the one-step sharp magnetization reversal is realized and giant magnetoelectric coefficients are achieved. Our study reveals that tuning magnetic symmetry is an effective route to enhance the magnetoelectric effects also in multiferroic hexaferrites.

36 MATERIALS SCIENCE↗