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DOE OSTI2015

WE-EF-BRD-03: I Want It Now!: Advances in MRI Acquisition, Reconstruction and the Use of Priors to Enable Fast Anatomic and Physiologic Imaging to Inform Guidance and Adaptation Decisions

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

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-EF-BRD-04: MR in the OR: The Growth and Applications of MRI for Interventional Radiology and Surgery

60 APPLIED LIFE SCIENCES↗

NASA NTRS1986

M.I.T./Canadian vestibular experiments on the Spacelab-1 mission: 6. Vestibular reactions to lateral acceleration following ten days of weightlessness

Tests of otolith function were performed pre-flight and post-flight on the science crew of the first Spacelab Mission with a rail-mounted linear acceleration sled. Four tests were performed using horizontal lateral (y-axis) acceleration: perception of linear motion, a closed loop nulling task, dynamic ocular torsion, and lateral eye deviations. The motion perception test measured the time to detect the onset and direction of near threshold accelerations. Post-flight measures of threshold and velocity constant obtained during the days immediately following the mission showed no consistent pattern of change among the four crewmen compared to their pre-flight baseline other than an increased variability of response. In the closed loop nulling task, crewmen controlled the motion of the sled and attempted to null a computer-generated random disturbance motion. When performed in the light, no difference in ability was noted between pre-flight and post-flight. In the dark, however, two of the four crewmen exhibited somewhat enhanced performance post-flight. Dynamic ocular torsion was measured in response to sinusoidal lateral acceleration which produces a gravitionertial stimulus equivalent to lateral head tilt without rotational movement of the head. Results available for two crewmen suggest a decreased amplitude of sinusoidal ocular torsion when measured on the day of landing (R+0) and an increasing amplitude when measured during the week following the mission.

short duration↗

DOE OSTI2015

WE-G-BRA-02: SafetyNet: Automating Radiotherapy QA with An Event Driven Framework

Purpose: Quality assurance is an essential task in radiotherapy that often requires many manual tasks. We investigate the use of an event driven framework in conjunction with software agents to automate QA and eliminate wait times. Methods: An in house developed subscription-publication service, EventNet, was added to the Aria OIS to be a message broker for critical events occurring in the OIS and software agents. Software agents operate without user intervention and perform critical QA steps. The results of the QA are documented and the resulting event is generated and passed back to EventNet. Users can subscribe to those events and receive messages based on custom filters designed to send passing or failing results to physicists or dosimetrists. Agents were developed to expedite the following QA tasks: Plan Revision, Plan 2nd Check, SRS Winston-Lutz isocenter, Treatment History Audit, Treatment Machine Configuration. Results: Plan approval in the Aria OIS was used as the event trigger for plan revision QA and Plan 2nd check agents. The agents pulled the plan data, executed the prescribed QA, stored the results and updated EventNet for publication. The Winston Lutz agent reduced QA time from 20 minutes to 4 minutes and provided a more accurate quantitative estimate of radiation isocenter. The Treatment Machine Configuration agent automatically reports any changes to the Treatment machine or HDR unit configuration. The agents are reliable, act immediately, and execute each task identically every time. Conclusion: An event driven framework has inverted the data chase in our radiotherapy QA process. Rather than have dosimetrists and physicists push data to QA software and pull results back into the OIS, the software agents perform these steps immediately upon receiving the sentinel events from EventNet. Mr Keranen is an employee of Varian Medical Systems. Dr. Moran’s institution receives research support for her effort for a linear accelerator QA project from Varian Medical Systems. Other quality projects involving her effort are funded by Blue Cross Blue Shield of Michigan, Breast Cancer Research Foundation, and the NIH.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2014

Optimal Location of Radiation Therapy Centers With Respect to Geographic Access

Purpose: To develop a framework with which to evaluate locations of radiation therapy (RT) centers in a region based on geographic access. Methods and Materials: Patient records were obtained for all external beam radiation therapy started in 2011 for the province of British Columbia, Canada. Two metrics of geographic access were defined. The primary analysis was percentage of patients (coverage) within a 90-minute drive from an RT center (C90), and the secondary analysis was the average drive time (ADT) to an RT center. An integer programming model was developed to determine optimal center locations, catchment areas, and capacity required under different scenarios. Results: Records consisted of 11,096 courses of radiation corresponding to 161,616 fractions. Baseline geographic access was estimated at 102.5 minutes ADT (each way, per fraction) and 75.9% C90. Adding 2 and 3 new centers increased C90 to 88% and 92%, respectively, and decreased ADT by between 43% and 61%, respectively. A scenario in which RT was provided in every potential location that could support at least 1 fully utilized linear accelerator resulted in 35.3 minutes' ADT and 93.6% C90. Conclusions: The proposed framework and model provide a data-driven means to quantitatively evaluate alternative configurations of a regional RT system. Results suggest that the choice of location for future centers can significantly improve geographic access to RT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2014

SU-E-T-348: Verification MU Calculation for Conformal Radiotherapy with Multileaf Collimator Using Report AAPM TG 114

Purpose: The purpose of this work was to develop and validate an open source independent MU dose calculation software for 3D conformal radiotherapy with multileaf high and low resolution according to the report of AAPM TG 11 Methods: Treatment plans were done using Iplan v4.5 BrainLAB TPS. A 6MV photon beam produced by Primus and Novalis linear accelerators equipped with an Optifocus MLC and HDMLC, respectively. TPS dose calculation algorithms were pencil beam and Monte Carlo. 1082 treatments plans were selected for the study. The algorithm was written in free and open source CodeBlocks C++ platform. Treatment plans were imported by the software using RTP format. Equivalent size field is obtained from the positions of the leaves; the effective depth of calculation can be introduced by TPS's dosimetry report or automatically calculated starting from SSD. The inverse square law is calculated by the 3D coordinates of the isocenter and normalization point of the treatment plan. The dosimetric parameters TPR, Sc, Sp and WF are linearly interpolated. Results: 1082 plans of both machines were analyzed. The average uncertainty between the TPS and the independent calculation was −0.43% ± 2.42% [−7.90%, 7.50%]. Specifically for the Primus the variation obtained was −0.85% ± 2.53% and for the Novalis 0.00% ± 2.23%. Data show that 94.8% of the cases the uncertainty was less than or equal to 5%, while 98.9% is less than or equal to 6%. Conclusion: The developed software is appropriate for use in calculation of UM. This software can be obtained upon request.

07 ISOTOPE AND RADIATION SOURCES↗

DOE OSTI2016

TH-CD-BRA-08: Novel Iron-Based Radiation Reporting Systems as 4D Dosimeters for MR-Guided Radiation Therapy

Purpose: To compare novel radiation reporting systems utilizing ferric ion (Fe{sup 3+}) reduction versus ferrous ion (Fe{sup 2+}) oxidation in gelatin matrixes for 3D and 4D (3D+time) MR-guided radiation therapy dosimetry. Methods: Dosimeters were irradiated using an integrated 1.5T MRI and 7MV linear accelerator (MR-Linac). Dosimeters were read-out with both a spectrophotometer and the MRI component of the MR-Linac immediately after irradiation. Changes in optical density (OD) were measured using a spectrophotometer; changes in MR signal intensity due to the paramagnetic differences in the iron ions were measured using the MR-Linac in real-time during irradiation (balanced-FFE sequences) and immediately after irradiation (T{sub 1}-weighted and inversion recovery sequences). Results: Irradiation of Fe{sup 3+} reduction dosimeters resulted in a stable red color with an absorbance peak at 512 nm. The change in OD relative to dose exhibited a linear response up to 100 Gy (R{sup 2}=1.00). T{sub 1}-weighted-MR signal intensity (SI) changed minimally after irradiation with increases of 8.0% for 17 Gy and 9.7% after escalation to 35 Gy compared to the un-irradiated region. Irradiation of Fe{sup 2+} oxidation dosimeters resulted in a stable purple color with absorbance peaks at 440 and 585 nm. The changes in OD, T{sub 1}-weighted-MR SI, and R{sub 1} relative to dose exhibited a linear response up to at least 8 Gy (R{sup 2}=1.00, 0.98, and 0.99) with OD saturation above 40 Gy. The T{sub 1}-weighted-MR SI increased 50.3% for 17 Gy compared to the un-irradiated region. The change in SI was observed in both 2D+time and 4D (3D+time) acquisitions post-irradiation and in real-time during irradiation with a linear increase with respect to dose (R{sup 2}>0.93). Conclusion: The Fe{sup 2+} oxidation-based system was superior as 4D dosimeters for MR-guided radiation therapy due to its higher sensitivity in both optical and MR signal readout and feasibility for real-time 4D dose readout. The Fe{sup 3+} reduction system is recommended for high dose applications. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. LH-102SPS.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

Treatment planning for SBRT using automated field delivery: A case study

Stereotactic body radiation therapy (SBRT) treatment planning and delivery can be accomplished using a variety of techniques that achieve highly conformal dose distributions. Herein, we describe a template-based automated treatment field approach that enables rapid delivery of more than 20 coplanar fields. A case study is presented to demonstrate how modest adaptations to traditional SBRT planning can be implemented to take clinical advantage of this technology. Treatment was planned for a left-sided lung lesion adjacent to the chest wall using 25 coplanar treatment fields spaced at 11° intervals. The plan spares the contralateral lung and is in compliance with the conformality standards set forth in Radiation Therapy and Oncology Group protocol 0915, and the dose tolerances found in the report of the American Association of Physicists in Medicine Task Group 101. Using a standard template, treatment planning was accomplished in less than 20 minutes, and each 10 Gy fraction was delivered in approximately 5.4 minutes. For those centers equipped with linear accelerators capable of automated treatment field delivery, the use of more than 20 coplanar fields is a viable SBRT planning approach and yields excellent conformality and quality combined with rapid planning and treatment delivery. Although the case study discusses a laterally located lung lesion, this technique can be applied to centrally located tumors with similar results.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2016

Investigating ion recombination effects in a liquid-filled ionization chamber array used for IMRT QA measurements

Purpose: PTW’s Octavius 1000 SRS array performs IMRT quality assurance (QA) measurements with liquid-filled ionization chambers (LICs) to allow closer detector spacing and higher resolution, compared to air-filled QA devices. However, reduced ion mobility in LICs relative to air leads to increased ion recombination effects and reduced collection efficiencies that are dependent on Linac pulse frequency and pulse dose. These pulse parameters are variable during an IMRT delivery, which affects QA results. In this study, (1) 1000 SRS collection efficiencies were measured as a function of pulse frequency and pulse dose, (2) two methods were developed to correct changes in collection efficiencies during IMRT QA measurements, and the effects of these corrections on QA pass rates were compared. Methods: To obtain collection efficiencies, the OCTAVIUS 1000 SRS was used to measure open fields of varying pulse frequency, pulse dose, and beam energy with results normalized to air-filled chamber measurements. Changes in ratios of 1000 SRS to chamber measured dose were attributed to changing collection efficiencies, which were then correlated to pulse parameters using regression analysis. The usefulness of the derived corrections was then evaluated using 6 MV and 10FFF SBRT RapidArc plans delivered to the OCTAVIUS 4D system using a TrueBeam (Varian Medical Systems) linear accelerator equipped with a high definition multileaf collimator. For the first correction, MATLAB software was developed that calculates pulse frequency and pulse dose for each detector, using measurement and DICOM RT Plan files. Pulse information is converted to collection efficiency, and measurements are corrected by multiplying detector dose by ratios of calibration to measured collection efficiencies. For the second correction the MU/min in the daily 1000 SRS calibration was chosen to match the average MU/min of the volumetric modulated arc therapy plan. Effects of the two corrections on QA results were examined by performing 3D gamma analysis comparing predicted to measured dose, with and without corrections. Results: Collection efficiencies correlated linearly to pulse dose, while correlations with pulse frequency were less defined, generally increasing as pulse frequency decreased. After complex MATLAB corrections, average 3D gamma pass rates improved by [0.07%,0.40%,1.17%] for 6 MV and [0.29%,1.40%,4.57%] for 10FFF using [3%/3 mm,2%/2 mm,1%/1 mm] criteria. Maximum changes in gamma pass rates were [0.43%,1.63%,3.05%] for 6 MV and [1.00%,4.80%,11.2%] for 10FFF using [3%/3 mm,2%/2 mm,1%/1 mm] criteria. On average, pass rates of simple daily calibration corrections were within 1% of complex MATLAB corrections. Conclusions: OCTAVIUS 1000 SRS ion recombination effects have little effect on 6 MV measurements. However, the effect could potentially be clinically significant for higher pulse dose unflattened beams when using tighter gamma tolerances, especially when small aperture sizes are used, as is common for SRS/SBRT. In addition, ion recombination effects are strongly correlated to changing MU/min, therefore MU/min used in daily 1000 SRS calibrations should be matched to the expected average MU/min of the IMRT plan.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2023

Ultralightweight Power System for Human-Portable Linac-Based X-Ray Sources

Industrial human-portable X-ray sources are widely used by security, nuclear safeguard, and defense agencies. However, the employed sources have significant energy, dose, size, weight, and power (SWaP) limitations, greatly affecting their practical application. RF linear accelerators (linacs) can serve as a flexible, reliable, and robust type of X-ray source if they can match the size, weight, cost, and imaging performance requirements of conventional ones. One of the most critical elements affecting these parameters is the high-voltage pulsed power supply system or modulator, which can make the largest contribution to the total weight and dimensions of the accelerator. Here, in this article, we present the design and demonstration results of a novel ultra lightweight power system based on a 24-kV solid-state Marx modulator for a hand-portable 0.15–2.0-MeV Ku -band linac-based X-ray source.

47 OTHER INSTRUMENTATION↗

DOE OSTI2014

An analytical method to calculate equivalent fields to irregular symmetric and asymmetric photon fields

Equivalent field is frequently used for central axis depth-dose calculations of rectangular- and irregular-shaped photon beams. As most of the proposed models to calculate the equivalent square field are dosimetry based, a simple physical-based method to calculate the equivalent square field size was used as the basis of this study. The table of the sides of the equivalent square or rectangular fields was constructed and then compared with the well-known tables by BJR and Venselaar, et al. with the average relative error percentage of 2.5 ± 2.5% and 1.5 ± 1.5%, respectively. To evaluate the accuracy of this method, the percentage depth doses (PDDs) were measured for some special irregular symmetric and asymmetric treatment fields and their equivalent squares for Siemens Primus Plus linear accelerator for both energies, 6 and 18 MV. The mean relative differences of PDDs measurement for these fields and their equivalent square was approximately 1% or less. As a result, this method can be employed to calculate equivalent field not only for rectangular fields but also for any irregular symmetric or asymmetric field.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2014

SU-E-T-48: Automated Quality Assurance for XML Controlled Linacs

Purpose: To automate routine imaging QA procedures so that complying with TG 142 and TG 179 can be efficient and reliable. Methods: Two QA tests for a True Beam Linac were automatized. A Winston Lutz test as described by Lutz et al{sup 1} using the Winston Lutz test kit from BrainLab, Germany and a CBCT Image Quality test as described in TG 179 using the EMMA phantom, Siemens Medical Physics, Germany were performed in our True Beam. For each QA procedure tested, a 3 step paradigm was used. First, the data was automatically acquired using True Beam Developer Mode and XML scripting. Second, the data acquired in the first step was automatically processed using in-home grown Matlab GUIs. Third, Machine Learning algorithms were used to automatically classify the processed data and reports generated. Results: The Winston Luzt test could be performed by an experienced medical physicist in 29.0 ± 8.0 min. The same test, if automated using our paradigm, could be performed in 3.0 ± 0.1 min. In the same lieu, time could be substantially saved for image quality tests. In this case, the amount of time saved will depend on the phantoms used and the initial localization method. Additionally, machine learning algorithms could automatically identify the roots of the problems if any and possibly help reduce machine down time. Conclusion: Modern linear accelerators are equipped with advanced 2D and 3D imaging that are used for patient alignment substantially improving IGRT protocols. However, this extra complexity exponentially increases the number of QA tests needed. Using the new paradigm described above, not only bare minimum but best practice QA programs could be implemented with the same manpower. This work is supported by Varian, Palo Alto, CA.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-78: Minimum Data Set of Measurements for TG 71 Based Electron Monitor-Unit Calculations

Purpose: Building up a TG-71 based electron monitor-unit (MU) calculation protocol usually involves massive measurements. This work investigates a minimum data set of measurements and its calculation accuracy and measurement time. Methods: For 6, 9, 12, 16, and 20 MeV of our Varian Clinac-Series linear accelerators, the complete measurements were performed at different depth using 5 square applicators (6, 10, 15, 20 and 25 cm) with different cutouts (2, 3, 4, 6, 10, 15 and 20 cm up to applicator size) for 5 different SSD’s. For each energy, there were 8 PDD scans and 150 point measurements for applicator factors, cutout factors and effective SSDs that were then converted to air-gap factors for SSD 99–110cm. The dependence of each dosimetric quantity on field size and SSD was examined to determine the minimum data set of measurements as a subset of the complete measurements. The “missing” data excluded in the minimum data set were approximated by linear or polynomial fitting functions based on the included data. The total measurement time and the calculated electron MU using the minimum and the complete data sets were compared. Results: The minimum data set includes 4 or 5 PDD’s and 51 to 66 point measurements for each electron energy, and more PDD’s and fewer point measurements are generally needed as energy increases. Using only <50% of complete measurement time, the minimum data set generates acceptable MU calculation results compared to those with the complete data set. The PDD difference is within 1 mm and the calculated MU difference is less than 1.5%. Conclusion: Data set measurement for TG-71 electron MU calculations can be minimized based on the knowledge of how each dosimetric quantity depends on various setup parameters. The suggested minimum data set allows acceptable MU calculation accuracy and shortens measurement time by a few hours.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2015

Measuring neutron spectra in radiotherapy using the nested neutron spectrometer

Purpose: Out-of-field neutron doses resulting from photonuclear interactions in the head of a linear accelerator pose an iatrogenic risk to patients and an occupational risk to personnel during radiotherapy. To quantify neutron production, in-room measurements have traditionally been carried out using Bonner sphere systems (BSS) with activation foils and TLDs. In this work, a recently developed active detector, the nested neutron spectrometer (NNS), was tested in radiotherapy bunkers. Methods: The NNS is designed for easy handling and is more practical than the traditional BSS. Operated in current-mode, the problem of pulse pileup due to high dose-rates is overcome by measuring current, similar to an ionization chamber. In a bunker housing a Varian Clinac 21EX, the performance of the NNS was evaluated in terms of reproducibility, linearity, and dose-rate effects. Using a custom maximum-likelihood expectation–maximization algorithm, measured neutron spectra at various locations inside the bunker were then compared to Monte Carlo simulations of an identical setup. In terms of dose, neutron ambient dose equivalents were calculated from the measured spectra and compared to bubble detector neutron dose equivalent measurements. Results: The NNS-measured spectra for neutrons at various locations in a treatment room were found to be consistent with expectations for both relative shape and absolute magnitude. Neutron fluence-rate decreased with distance from the source and the shape of the spectrum changed from a dominant fast neutron peak near the Linac head to a dominant thermal neutron peak in the moderating conditions of the maze. Monte Carlo data and NNS-measured spectra agreed within 30% at all locations except in the maze where the deviation was a maximum of 40%. Neutron ambient dose equivalents calculated from the authors’ measured spectra were consistent (one standard deviation) with bubble detector measurements in the treatment room. Conclusions: The NNS may be used to reliably measure the neutron spectrum of a radiotherapy beam in less than 1 h, including setup and data unfolding. This work thus represents a new, fast, and practical method for neutron spectral measurements in radiotherapy.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

An Evaluation of Bipolar Junction Transistors as Dosimeter for Megavoltage Electron Beams

Dosimetry is an extremely important field in medical applications of radiation and nowadays, electron beam is a good option for superficial tumor radiotherapy. Normally, the applied dose to the patient both in diagnostic and therapy must be monitored to prevent injuries and ensure the success of the treatment, therefore, we should always look for improving of the dosimetric methods. Accordingly, the aim of this work is about the use of a bipolar junction transistor (BJT) for electron beam dosimetry. After previous studies, such an electronic device can work as a dosimeter when submitted to ionizing radiation of photon beam. Actually, a typical BJT consists of two PN semiconductor junctions resulting in the NPN structure device, for while, and each semiconductor is named as collector (C), base (B) and emitter (E), respectively. Although the transistor effect, which corresponds to the current amplification, be accurately described by the quantum physics, one can utilize a simple concept from the circuit theory: the base current IB (input signal) is amplified by a factor of β resulting in the collector current IC (output signal) at least one hundred times greater the IB. In fact, the BJT is commonly used as a current amplifier with gain β=I{sub C}/I{sub B}, therefore, it was noticed that this parameter is altered when the device is exposed to ionizing radiation. The current gain alteration can be explained by the trap creation and the positive charges build up, beside the degradation of the lattice structure. Then, variations of the gain of irradiated transistors may justify their use as a dosimeter. Actually, the methodology is based on the measurements of the I{sub C} variations whereas I{sub B} is maintained constant. BC846 BJT type was used for dose monitoring from passive-mode measurements: evaluation of its electrical characteristic before and after irradiation procedure. Thus, IC readings were plotted as a function of the applied dose in 6 MeV electron beam from a linear accelerator, Clinac iX. The results show that this new methodology could be an alternative to study the dose in superficial tumors in radiation oncology. (authors)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

DOE OSTI2015

Accuracy of Robotic Radiosurgical Liver Treatment Throughout the Respiratory Cycle

Purpose: To quantify random uncertainties in robotic radiosurgical treatment of liver lesions with real-time respiratory motion management. Methods and Materials: We conducted a retrospective analysis of 27 liver cancer patients treated with robotic radiosurgery over 118 fractions. The robotic radiosurgical system uses orthogonal x-ray images to determine internal target position and correlates this position with an external surrogate to provide robotic corrections of linear accelerator positioning. Verification and update of this internal–external correlation model was achieved using periodic x-ray images collected throughout treatment. To quantify random uncertainties in targeting, we analyzed logged tracking information and isolated x-ray images collected immediately before beam delivery. For translational correlation errors, we quantified the difference between correlation model–estimated target position and actual position determined by periodic x-ray imaging. To quantify prediction errors, we computed the mean absolute difference between the predicted coordinates and actual modeled position calculated 115 milliseconds later. We estimated overall random uncertainty by quadratically summing correlation, prediction, and end-to-end targeting errors. We also investigated relationships between tracking errors and motion amplitude using linear regression. Results: The 95th percentile absolute correlation errors in each direction were 2.1 mm left–right, 1.8 mm anterior–posterior, 3.3 mm cranio–caudal, and 3.9 mm 3-dimensional radial, whereas 95th percentile absolute radial prediction errors were 0.5 mm. Overall 95th percentile random uncertainty was 4 mm in the radial direction. Prediction errors were strongly correlated with modeled target amplitude (r=0.53-0.66, P<.001), whereas only weak correlations existed for correlation errors. Conclusions: Study results demonstrate that model correlation errors are the primary random source of uncertainty in Cyberknife liver treatment and, unlike prediction errors, are not strongly correlated with target motion amplitude. Aggregate 3-dimensional radial position errors presented here suggest the target will be within 4 mm of the target volume for 95% of the beam delivery.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

DOE OSTI2013

Ideas for fundamental electron scattering at the S-DALINAC

A source of polarized electrons has recently been added to the superconducting Darmstadt electron linear accelerator S-DALINAC. This contribution briefly addresses the present status of the facility and foreseen extensions along with examples for possible future experiments with polarized beams. In particular, the determination of the fifth structure function in (e,e′x) reactions, the measurement of the Mott scattering analyzing strength at several 10 MeV near 180°, and the determination of bremsstrahlung polarization depending on electron spin polarization will be discussed.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

DOE OSTI2016

SU-F-T-263: Dosimetric Characteristics of the Cine Acquisition Mode of An A-Si EPID

Purpose: To investigate the dosimetric characteristics of Varian a-Si-500 electronic portal imaging device (EPID) operated in cine mode particularly considering linearity with delivered dose, dose rate, field size, phantom thickness, MLC speed and common IMRT fields. Methods: The EPID that attached to a Varian Clinac 21iX linear accelerator, was irradiated with 6 and 18 MV using 600 MU/min. Image acquisition is controlled by the IAS3 software, Trigger delay was 6 ms, BeamOnDelay and FrameStartDelay were zero. Different frame rates were utilized. Cine mode response was calculated using MATLAB as summation of mean pixel values in a region of interest of the acquired images. The performance of cine mode was compared to integrated mode and dose measurements in water using CC13 ionization chamber. Results: Figure1 illustrates that cine mode has nonlinear response for small MU, when delivering 10 MU was about 0.5 and 0.64 for 6 and 18 MV respectively. This is because the missing acquired images that were calculated around four images missing in each delivery. With the increase MU the response became linear and comparable with integrated mode and ionization chamber within 2%. Figure 2 shows that cine mode has comparable response with integrated mode and ionization chamber within 2% with changing dose rate for 10 MU delivered. This indicates that the dose rate change has no effect on nonlinearity of cine mode response. Except nonlinearity, cine mode is well matched to integrated mode response within 2% for field size, phantom thickness, MLC speed dependences. Conclusion: Cine mode has similar dosimetric characteristics to integrated mode with open and IMRT fields, and the main limitation with cine mode is missing images. Therefore, the calibration of EPID images with this mode should be run with large MU, and when IMRT verification field has low MU, the correction for missing images are required.

60 APPLIED LIFE SCIENCES↗