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At least 757 records · Page 42
All sourcesNASA NTRSDOE OSTI
DOE OSTI2014

SU-E-I-95: Personalized Radiography Technical Parameters for Each Patient and Exam

Purpose: To determine exact electrical parameters (kV, mAs) a radiological technologist shall use taking account the exam and patient's structure, with guarantee of minimum dose and adequate quality image. Methods: A patient's absorbed dose equation was developed by means of Entrance Skin Dose (ESD), irradiated area and patient width for specific anatomy. ESD is calculated from a developed equation, where entrance surface air-KERMA and backscatter factor are included, with air-to-skin coefficient conversion. We developed specific Lambert-Beer attenuation equations derived from mass energy-absorption coefficients data for skin, fat, and muscle and bone as one tissue. Anatomy tissue thickness distribution at central X-ray location in anteroposterior incidence for hand and chest, was estimate by discounting constant skin and bone thickness from patient measured width, assuming the result as muscle and fat. A clinical research at a big hospital were executed when real parameters (kV, mAs, filtration, ripple) used by technologists were combined with the image quality and patient's data: anatomy width, height and weight. A correlation among the best images acquired and electrical parameters used were confronted with patient's data and dose estimation. The best combinations were used as gold standards. Results: For each anatomy, two equations were developed to calculate voltage (kV) and exposure (mAs) to reproduce and interpolate the gold standards. Patient is measured and data are input into equations, giving radiological technologists the right set of electrical parameters for that specific exam. Conclusion: This work indicates that radiological technologist can personalize the exact electrical parameters for each patient exam, instead of using standard values. It also guarantee that patients under or over-sized measures will receive the right dose for the best image. It will stop wrong empiric adjusts technologists do when examining a non-standard patient and reduce probability of radiography retaken because of over or under exposition.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-72: Geant4 Simulations of Spot-Scanned Proton Beam Treatment Plans

Purpose: To evaluate density inhomogeneities which can effect dose distributions for real-time image gated spot-scanning proton therapy (RGPT), a dose calculation system, using treatment planning system VQA (Hitachi Ltd., Tokyo) spot position data, was developed based on Geant4. Methods: A Geant4 application was developed to simulate spot-scanned proton beams at Hokkaido University Hospital. A CT scan (0.98 × 0.98 × 1.25 mm) was performed for prostate cancer treatment with three or four inserted gold markers (diameter 1.5 mm, volume 1.77 mm3) in or near the target tumor. The CT data was read into VQA. A spot scanning plan was generated and exported to text files, specifying the beam energy and position of each spot. The text files were converted and read into our Geant4-based software. The spot position was converted into steering magnet field strength (in Tesla) for our beam nozzle. Individual protons were tracked from the vacuum chamber, through the helium chamber, steering magnets, dose monitors, etc., in a straight, horizontal line. The patient CT data was converted into materials with variable density and placed in a parametrized volume at the isocenter. Gold fiducial markers were represented in the CT data by two adjacent voxels (volume 2.38 mm3). 600,000 proton histories were tracked for each target spot. As one beam contained about 1,000 spots, approximately 600 million histories were recorded for each beam on a blade server. Two plans were considered: two beam horizontal opposed (90 and 270 degree) and three beam (0, 90 and 270 degree). Results: We are able to convert spot scanning plans from VQA and simulate them with our Geant4-based code. Our system can be used to evaluate the effect of dose reduction caused by gold markers used for RGPT. Conclusion: Our Geant4 application is able to calculate dose distributions for spot scanned proton therapy.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-237: Monte Carlo Dosimetric Characterization of the Mobetron Mobile Linac

Purpose: The aim of this work is to characterize dosimetrically a clinical intraoperative electron beam accelerator, Mobetron (IntraOp Medical, Inc.) in clinical use in our Hospital. Once this first step is completed our purpose is to evaluate shielding requirements for such a device by preparing adequate phase space files. Methods: It is known that electron beam simulation parameters required for state-of-the-art Monte Carlo codes to obtain a good match with measured data, like the mean energy or the FWHM, may not be code-independent due to the different set of process simulated and formalisms involved. Then, to cross-check our results against any issue in the simulation we have compared experimental data (PDD and profiles for electrons in the range 4 to 12 MeV) with simulations performed independently using both Penelope2011 and Geant4 codes. To do so, the geometry and materials of the head of the accelerator have been fully characterized following information provided by the manufacturer. Results: Both simulations agree with experimental data within experimental uncertainties (±1 mm displacement), although small variations (less than 10%) in the mean energy and FWHM are required to match measured values depending on the code used. Conclusion: Independent Monte Carlo simulations were used to obtain an excellent match to measured electron dose distributions. This opens the road to use such data for evaluating shielding requirements which is the main objective of this project.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-571: Microdosimetric Characterization of Proton Biological Effectiveness

Purpose: The knowledge of cell repair kinetics is critical in order to understand relevant aspects of proton therapy such optimal fractionation. High LET radiation induces larger proportions of more complex DSBs that might not be resolved in standard interfractional times (24h). We propose a method to characterize the cell repair kinetic at different positions within the spread-out Bragg peak (i.e. as a function of proton LETd) and use this information to model normal tissue complication probabilities (NTCP) as a function of LETd Methods: Repair kinetics curves will be obtained using U251-glioblastoma cells plating over microscope slides that are immersed in culture-medium that will be exposed along the axis of a proton-beam (10cm in range, 2cm modulation) of 1Gy. Culture is immersed within a solid-water block to place the distal edge of the proton-beam within the slide. gamma-H2AX foci along the slide in the beam axis is imaged with a microscope at different positions in order to correlate number of gamma-H2AX foci with dose and LET, where dose is obtained from a strip of gafchromic film placed on the side of the slide. Each slide is fixed at different time points. Results: We will present the correlation between an increase of LET and the increase of the gamma-H2AX along the depth within the proton beam, at different post-irradiation times and doses. Different fractions of unrepaired damage at 24h after irradiation will be presented at each depth of the proton beam, with larger fractions at the distal edge of the beam, where normal tissue exist. Larger values of NTCP are therefore observed at the distal edge. Conclusion: Slower repair kinetics is observed at the distal edge of a proton beam, and this study shows a method to obtain such information and the correlation between increased LET and increased NTCP. This research is supported by the Department of Radiation Oncology at the Hospital of the University of Pennsylvania as a pilot project.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

SU-E-T-572: Beam Characteristics and Treatment Planning Commissioning for a New Proton Therapy Unit

Purpose: A single-room proton system, the Mevion S250, was introduced into the arena of proton radiotherapy by Mevion Medical Systems. The first unit was installed and operates at the S. Lee Kling Proton Therapy Center at Barnes-Jewish Hospital. The objective of this abstract is to report the system's beam characteristics and Eclipse commissioning. Methods: Commissioning data were acquired for modelling longitudinal fluence, virtual source position, effective source position, source size and Bragg peaks in Eclipse. Stoichiometric CT calibration was generated via ICRU44 human. Spread-out Bragg peaks (SOBP) were measured with Parallel Plate Chamber and profiles with solid state detector for model validation. Heterogeneity effects were measured with bone and lung inserts in the beam line. RT dose was computed in a virtual water phantom, and exported from Eclipse to compare with measurements at various depths and axis. SOBPs were fine-tuned with partial shining correction and entry correction to match measurements. Output factor was measured for each individual field with an ADCL ion chamber in a water tank and fitted to a polynomial function to cross-check the monitor unit verification. Results: Ranges of all 24 options were measured within ±1mm tolerance. Modulations met a ±1mm or ±2% tolerance. SOBP flatness met a ±3% tolerance. Distal fall off (80%-20%) were measured between 6mm and 7mm for all options. Virtual source positions varied between 177cm and 195cm, decreasing with field size and range. SOBP generated by Eclipse agreed with measurements within ±3% in the entry region, and ±1%/±1mm in other regions. Sanity check for output achieved 5% accuracy in 98% of cases. Conclusion: The commissioning of the first Mevions S250 proton therapy system met specifications. The unit has been put in clinical operation since 12/17/2013.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-T-632: A Dosimetric Comparison of the 3D-CRT Planning of Chest Wall in Post-Mastectomy Breast Cancer Patients, with and Without Breast Board Setup

Purpose: Breast boards are used in breast radiation which increases normal lung and heart doses, when supraclavicular field is included. Therefore, in this study through dose volume histogram (DVHs), lung and heart doses comparison was done between two different setups i.e. with and without breast board, for the treatment of left chest wall and supraclavicular fossa in postmastectomy left breast cancer. Methods: In this study, CT-Simulation scans of ten breast cancer patients were done with and without breast board, at Shifa International Hospitals Islamabad, to investigate the differences between the two different setups of the irradiation of left chest wall in terms of lung and heart doses. For immobilization, support under the neck, shoulders and arms was used. Precise PLAN 2.15 treatment planning system (TPS) was used for 3D-CRT planning. The total prescribed dose for both the plans was 5000 cGy/25 fractions. The chest wall was treated with a pair of tangential photon fields and the upper supraclavicular nodal regions were treated with an anterior photon field. A mono-isocentric technique was used to match the tangential fields with the anterior field at the isocentre. The dose volume histogram was used to compare the doses of heart and ipsilateral lung. Results: Both the plans of each patient were generated and compared. DVH results showed that for the same PTV dose coverage, plans without breast board resulted in a reduction of lung and heart doses compared with the plans with breast board. There was significant reductions in V20, V<25 and mean doses for lung and V<9 and mean doses for heart. Conclusion: In comparison of both the plans, setup without breast board significantly reduced the dose-volume of the ipsilateral lung and heart in left chest wall patients. Waived registration request has been submitted.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-F-BRD-08: Guaranteed Epsilon-Optimal Treatment Plans with Minimum Number of Beams for SBRT Using RayStation

Purpose: To efficiently find quality-guaranteed treatment plans with the minimum number of beams for stereotactic body radiation therapy using RayStation. Methods: For a pre-specified pool of candidate beams we use RayStation (a treatment planning software for clinical use) to identify the deliverable plan which uses all the beams with the minimum dose to organs at risk (OARs) and dose to the tumor and other structures in specified ranges. Then use the dose matrix information for the generated apertures from RayStation to solve a linear program to find the ideal plan with the same objective and constraints allowing use of all beams. Finally we solve a mixed integer programming formulation of the beam angle optimization problem (BAO) with the objective of minimizing the number of beams while remaining in a predetermined epsilon-optimality of the ideal plan with respect to the dose to OARs. Since the treatment plan optimization is a multicriteria optimization problem, the planner can exploit the multicriteria optimization capability of RayStation to navigate the ideal dose distribution Pareto surface and select a plan of desired target coverage versus OARs sparing, and then use the proposed technique to reduce the number of beams while guaranteeing quality. For the numerical experiments two liver cases and one lung case with 33 non-coplanar beams are considered. Results: The ideal plan uses an impractically large number of beams. The proposed technique reduces the number of beams to the range of practical application (5 to 9 beams) while remaining in the epsilon-optimal range of 1% to 5% optimality gap. Conclusion: The proposed method can be integrated into a general algorithm for fast navigation of the ideal dose distribution Pareto surface and finding the treatment plan with the minimum number of beams, which corresponds to the delivery time, in epsilon-optimality range of the desired ideal plan. The project was supported by the Federal Share of program income earned by Massachusetts General Hospital on C06 CA059267, Proton Therapy Research and Treatment Center and partially by RaySearch Laboratories.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

MO-B-16A-01: Memorial to Donald D. Tolbert - Memorial Lecture

The Medical Physics community lost one of its prominent leaders in April, 2013 with the passing of Donald D. Tolbert, PhD. He received his Doctorate at the University of Kansas followed by post Doctoral training at Florida State University and the University of Wisconsin. He was Chief of Radiation Therapy Medical Physics at the University of Wisconsin Hospital for 7 years before relocating to Honolulu Hawaii, where he founded the consulting group Mid-Pacific Medical Physics. Don was a leader in both the AAPM and the ACR, chairing the Professional Council and the Commission on Medical Physics. He was active on the AAPM Board of Directors and a member of the ACR Board of Chancellors. Dr. Tolbert's approach to the difficult problems of the times was admired and respected by colleagues in Medical Physics, Radiation Oncology, and Diagnostic Radiology. He always rose above the heated political rhetoric and led the discussion to higher ground. His wisdom was continually sought to solve complicated problems. Following retirement, he returned to homes in Kansas and Colorado, devoting his time to writing about coping with diabetes and providing support for Seniors in Beloit Kansas. Don is survived by his wife, Mattie, his 3 children and 5 grandchildren. He will be greatly missed.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗
DOE OSTI2014

MO-B-16A-02: In Memoriam of Donald D. Tolbert: Surviving the Politics of Radiation Therapy

Today's healthcare work environment is ever-changing and without a doubt will continue to do so for the foreseeable future. How physicists are employed, evaluated, and valued are important aspects of our careers. With increasing demands and challenges being placed on the medical physics workforce, it is important to have the skills and knowledge to prepare for potential challenges to the status-quo of our employment status. Surviving in a world of change, consolidation, increased workload, and financial constraints is not a given, and preparing for those changes and challenges will benefit individuals as well as the medical physics community at large. Learning Objectives: Understand the challenges of succeeding in different work environments. Learn strategies to help define the role of a medical physicist to various administrators, physicians, and department staff and directors. Learn how to successfully communicate and interact with University, Hospital, and Department administrators.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

MO-E-18A-01: Imaging: Best Practices In Pediatric Imaging

This imaging educational program will focus on solutions to common pediatric imaging challenges. The speakers will present collective knowledge on best practices in pediatric imaging from their experience at dedicated children's hospitals. Areas of focus will include general radiography, the use of manual and automatic dose management in computed tomography, and enterprise-wide radiation dose management in the pediatric practice. The educational program will begin with a discussion of the complexities of exposure factor control in pediatric projection radiography. Following this introduction will be two lectures addressing the challenges of computed tomography (CT) protocol optimization in the pediatric population. The first will address manual CT protocol design in order to establish a managed radiation dose for any pediatric exam on any CT scanner. The second CT lecture will focus on the intricacies of automatic dose modulation in pediatric imaging with an emphasis on getting reliable results in algorithmbased technique selection. The fourth and final lecture will address the key elements needed to developing a comprehensive radiation dose management program for the pediatric environment with particular attention paid to new regulations and obligations of practicing medical physicists. Learning Objectives: To understand how general radiographic techniques can be optimized using exposure indices in order to improve pediatric radiography. To learn how to establish diagnostic dose reference levels for pediatric patients as a function of the type of examination, patient size, and individual design characteristics of the CT scanner. To learn how to predict the patient's radiation dose prior to the exam and manually adjust technique factors if necessary to match the patient's dose to the department's established dose reference levels. To learn how to utilize manufacturer-provided automatic dose modulation technology to consistently achieve patient doses within the department's established size-based diagnostic reference range. To understand the key components of an enterprise-wide pediatric dose management program that integrates the expanding responsibilities of medial physicists in the new era of dose monitoring.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-C-12A-12: Veritas: An Open Source Tool to Facilitate User Interaction with TrueBeam Developer Mode

Purpose: To address the challenges of creating delivery trajectories and imaging sequences with TrueBeam Developer Mode, a new open-source graphical XML builder, Veritas, has been developed, tested and made freely available. Veritas eliminates most of the need to understand the underlying schema and write XML scripts, by providing a graphical menu for each control point specifying the state of 30 mechanical/dose axes. All capabilities of Developer Mode are accessible in Veritas. Methods: Veritas was designed using QT Designer, a ‘what-you-is-what-you-get’ (WYSIWIG) tool for building graphical user interfaces (GUI). Different components of the GUI are integrated using QT's signals and slots mechanism. Functionalities are added using PySide, an open source, cross platform Python binding for the QT framework. The XML code generated is immediately visible, making it an interactive learning tool. A user starts from an anonymized DICOM file or XML example and introduces delivery modifications, or begins their experiment from scratch, then uses the GUI to modify control points as desired. The software automatically generates XML plans following the appropriate schema. Results: Veritas was tested by generating and delivering two XML plans at Brigham and Women's Hospital. The first example was created to irradiate the letter ‘B’ with a narrow MV beam using dynamic couch movements. The second was created to acquire 4D CBCT projections for four minutes. The delivery of the letter ‘B’ was observed using a 2D array of ionization chambers. Both deliveries were generated quickly in Veritas by non-expert Developer Mode users. Conclusion: We introduced a new open source tool Veritas for generating XML plans (delivery trajectories and imaging sequences). Veritas makes Developer Mode more accessible by reducing the learning curve for quick translation of research ideas into XML plans. Veritas is an open source initiative, creating the possibility for future developments and collaboration with other researchers. I am an employee of Varian Medical Systems.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

TH-E-BRF-05: Comparison of Survival-Time Prediction Models After Radiotherapy for High-Grade Glioma Patients Based On Clinical and DVH Features

Purpose: Although many outcome prediction models based on dose-volume information have been proposed, it is well known that the prognosis may be affected also by multiple clinical factors. The purpose of this study is to predict the survival time after radiotherapy for high-grade glioma patients based on features including clinical and dose-volume histogram (DVH) information. Methods: A total of 35 patients with high-grade glioma (oligodendroglioma: 2, anaplastic astrocytoma: 3, glioblastoma: 30) were selected in this study. All patients were treated with prescribed dose of 30–80 Gy after surgical resection or biopsy from 2006 to 2013 at The University of Tokyo Hospital. All cases were randomly separated into training dataset (30 cases) and test dataset (5 cases). The survival time after radiotherapy was predicted based on a multiple linear regression analysis and artificial neural network (ANN) by using 204 candidate features. The candidate features included the 12 clinical features (tumor location, extent of surgical resection, treatment duration of radiotherapy, etc.), and the 192 DVH features (maximum dose, minimum dose, D95, V60, etc.). The effective features for the prediction were selected according to a step-wise method by using 30 training cases. The prediction accuracy was evaluated by a coefficient of determination (R{sup 2}) between the predicted and actual survival time for the training and test dataset. Results: In the multiple regression analysis, the value of R{sup 2} between the predicted and actual survival time was 0.460 for the training dataset and 0.375 for the test dataset. On the other hand, in the ANN analysis, the value of R{sup 2} was 0.806 for the training dataset and 0.811 for the test dataset. Conclusion: Although a large number of patients would be needed for more accurate and robust prediction, our preliminary Result showed the potential to predict the outcome in the patients with high-grade glioma. This work was partly supported by the JSPS Core-to-Core Program(No. 23003) and Grant-in-aid from the JSPS Fellows.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

CT reconstruction techniques for improved accuracy of lung CT airway measurement

Purpose: To determine the impact of constrained reconstruction techniques on quantitative CT (qCT) of the lung parenchyma and airways for low x-ray radiation dose. Methods: Measurement of small airways with qCT remains a challenge, especially for low x-ray dose protocols. Images of the COPDGene quality assurance phantom (CTP698, The Phantom Laboratory, Salem, NY) were obtained using a GE discovery CT750 HD scanner for helical scans at x-ray radiation dose-equivalents ranging from 1 to 4.12 mSv (12–100 mA s current–time product). Other parameters were 40 mm collimation, 0.984 pitch, 0.5 s rotation, and 0.625 mm thickness. The phantom was sandwiched between 7.5 cm thick water attenuating phantoms for a total length of 20 cm to better simulate the scatter conditions of patient scans. Image data sets were reconstructed using STANDARD (STD), DETAIL, BONE, and EDGE algorithms for filtered back projection (FBP), 100% adaptive statistical iterative reconstruction (ASIR), and Veo reconstructions. Reduced (half) display field of view (DFOV) was used to increase sampling across airway phantom structures. Inner diameter (ID), wall area percent (WA%), and wall thickness (WT) measurements of eight airway mimicking tubes in the phantom, including a 2.5 mm ID (42.6 WA%, 0.4 mm WT), 3 mm ID (49.0 WA%, 0.6 mm WT), and 6 mm ID (49.0 WA%, 1.2 mm WT) were performed with Airway Inspector (Surgical Planning Laboratory, Brigham and Women’s Hospital, Boston, MA) using the phase congruency edge detection method. The average of individual measures at five central slices of the phantom was taken to reduce measurement error. Results: WA% measures were greatly overestimated while IDs were underestimated for the smaller airways, especially for reconstructions at full DFOV (36 cm) using the STD kernel, due to poor sampling and spatial resolution (0.7 mm pixel size). Despite low radiation dose, the ID of the 6 mm ID airway was consistently measured accurately for all methods other than STD FBP. Veo reconstructions showed slight improvement over STD FBP reconstructions (4%–9% increase in accuracy). The most improved ID and WA% measures were for the smaller airways, especially for low dose scans reconstructed at half DFOV (18 cm) with the EDGE algorithm in combination with 100% ASIR to mitigate noise. Using the BONE + ASIR at half BONE technique, measures improved by a factor of 2 over STD FBP even at a quarter of the x-ray dose. Conclusions: The flexibility of ASIR in combination with higher frequency algorithms, such as BONE, provided the greatest accuracy for conventional and low x-ray dose relative to FBP. Veo provided more modest improvement in qCT measures, likely due to its compatibility only with the smoother STD kernel.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

Dosimetric characterization of two radium sources for retrospective dosimetry studies

Purpose: During the first part of the 20th century, {sup 226}Ra was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long-term radiation effects. The purpose of this work was to dosimetrically characterize two {sup 226}Ra sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose–effect studies. Methods: An 8 mg {sup 226}Ra tube and a 10 mg {sup 226}Ra needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiation transport codes: GEANT4 and MCNP5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG-43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG-43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a {sup 226}Ra point-like-source placed in the center of 1 m radius water sphere was calculated with GEANT4. Results: TG-43 parameters [including g{sub L}(r), F(r, θ), Λ, and s{sub K}] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG-43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been estimated that the uncertainty associated to the absorbed dose within the treatment volume is 10%–15%, whereas uncertainty of absorbed dose to distant organs is roughly 20%–25%. Conclusions: The results provided here facilitate retrospective dosimetry studies of {sup 226}Ra using modern treatment planning systems, which may be used to improve knowledge on long term radiation effects. It is surely important for the epidemiologic studies to be aware of the estimated uncertainty provided here before extracting their conclusions.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

SU-C-BRB-02: Symmetric and Asymmetric MLC Based Lung Shielding and Dose Optimization During Translating Bed TBI

Purpose: The primary aim was to introduce a dose optimization method for translating bed total body irradiation technique that ensures lung shielding dynamically. Symmetric and asymmetric dynamic MLC apertures were employed for this purpose. Methods: The MLC aperture sizes were defined based on the radiological depth values along the divergent ray lines passing through the individual CT slices. Based on these RD values, asymmetrically shaped MLC apertures were defined every 9 mm of the phantom in superior-inferior direction. Individual MLC files were created with MATLAB™ and were imported into Eclipse™ treatment planning system for dose calculations. Lungs can be shielded to an optimum level by reducing the MLC aperture width over the lungs. The process was repeated with symmetrically shaped apertures. Results: Dose-volume histogram (DVH) analysis shows that the asymmetric MLC based technique provides better dose coverage to the body and optimum shielding of the lungs compared to symmetrically shaped beam apertures. Midline dose homogeneity is within ±3% with asymmetric MLC apertures whereas it remains within ±4.5% with symmetric ones (except head region where it drops down to −7%). The substantial over and under dosage of ±5% at tissue interfaces has been reduced to ±2% with asymmetric MLC technique. Lungs dose can be reduced to any desired limit. In this experiment lungs dose was reduced to 80% of the prescribed dose, as was desired. Conclusion: The novel asymmetric MLC based technique assures optimum shielding of OARs (e.g. lungs) and better 3-D dose homogeneity and body-dose coverage in comparison with the symmetric MLC aperture optimization. The authors acknowledge the financial and infrastructural support provided by Pakistan Institute of Engineering & Applied Sciences (PIEAS), Islamabad and Aga Khan University Hospital (AKUH), Karachi during the course of this research project. Authors have no conflict of interest with any national / international body for the presented work.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-P-57: Radiation Doses Assessment to Paediatric Patients for Some Digital Diagnostic Radiology Examination in Emergency Department in Qatar

Purpose: The aim of this study was to evaluate radiation doses to pediatric patients undergoing standard radiographic examinations using Direct Digital Radiography (DDR) in Paediatric emergency center of Hamad General Hospital (HGH) in state of Qatar and compared with regional and international Dose Reference Levels (DRLs). Methods: Entrance Skin Dose (ESD) was measured for 2739 patients for two common X-ray examinations namely: Chest AP/PA, Abdomen. Exposure factors such as kV, mAs and Focal to Skin Distance (FSD) were recorded for each patient. Tube Output was measured for a range of selected kV values. ESD for each individual patient was calculated using the tube output and the technical exposure factors for each examination. The ESD values were compared with the some international Dose Reference Levels (DRL) for all types of examinations. Results: The most performed procedure during the time of this study was chest PA/PA (85%). The mean ESD values obtained from AP chest, PA chest and AP abdomen ranged 91–120, 80–84 and 209 – 659 µGy per radiograph for different age’s groups respectively. Two protocols have been used for chest AP and PA using different radiological parameters, and the different of ESD values for chest PA and were 41% for 1 years old child, 57% for 5 years old for chest AP. Conclusion: The mean ESD were compared with those found in literature and were found to be comparable. The radiation dose can be reduced more for Chest AP and PA examination by optimization of each investigation and hence more studies are required for this task. The results presented will serve as a baseline data needed for deriving local reference doses for pediatric X-ray examinations in this local department and hence it can be applied in the whole Qatar.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

SU-E-T-534: Level of Residual Radioactivity of Activated Parts of a Decommissioned Cyclotron

Purpose: CTI cyclotron RDS-111 was used at the Hong Kong Sanatorium and Hospital (HKSH) to produce radiopharmaceuticals and radioactive tracers for diagnostic scans between 1999 and 2007. During the operation, some machine components became radioactive by activation. For the safety of staff, decommissioning took place in 2009, two years after the cyclotron had stopped operation. This study investigates the residual radioactivity and radionuclides found in different cyclotron components in 2014 in compliance with the local regulations in Hong Kong for transfer of radioactive waste. Methods: A representative sample of each part was counted using a high-purity germanium detector (manufacturer: ORTECT) for at least four hours. GammaVision, a multichannel analyzer software, was used to identify the radionuclides found in the cyclotron components, as well as the associated activities. A standard library and a Mariscotti peak search algorithm were used to identify the present radionuclides. Only radionuclides with half-life greater than 180 days were considered. Results: Among the components, the Havar target foil has the highest specific activity ((4.6±0.6)×10{sup 2} Bq/g), with Co-60 being the most prominent ((3.8±0.5)×10{sup 2} Bq/g). The total activity of the target foil, however, is still low due to its small mass of 0.04 g. Radioisotopes Mn-54 (46±6 Bq/g), Na-22 (6.8±0.8 Bq/g), Co-57 (7.3±0.9 Bq/g), and Fe-59 (6.0±0.9 Bq/g) have also been detected in the target foil. The target window holder and the vacuum window register a specific activity of 88.3±0.6 Bq/g and 48.6±0.1 Bq/g, respectively. Other components, such as the collimator, the target tube, the valve body and the beamline, are also found with trace amounts of radionuclides. Conclusion: Even seven years after the cyclotron had stopped operation, some components still exhibited residual radioactivity from activation exceeding the IAEA clearance levels. Special consideration for radiological protection may need to be taken in the disposal of the cyclotron parts.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2015

SU-E-T-594: Out-Of-Field Neutron and Gamma Dose Estimated Using TLD-600/700 Pairs in the Wobbling Proton Therapy System

Purpose: Secondary fast neutrons and gamma rays are mainly produced due to the interaction of the primary proton beam with the beam delivery nozzle. These secondary radiation dose to patients and radiation workers are unwanted. The purpose of this study is to estimate the neutron and gamma dose equivalent out of the treatment volume during the wobbling proton therapy system. Methods: Two types of thermoluminescent (TL) dosimeters, TLD-600 ({sup 6}LiF: Mg, Ti) and TLD-700 ({sup 7}LiF: Mg, Ti) were used in this study. They were calibrated in the standard neutron and gamma sources at National Standards Laboratory. Annealing procedure is 400°C for 1 hour, 100°C for 2 hours and spontaneously cooling down to the room temperature in a programmable oven. Two-peak method (a kind of glow curve analysis technique) was used to evaluate the TL response corresponding to the neutron and gamma dose. The TLD pairs were placed outside the treatment field at the neutron-gamma mixed field with 190-MeV proton beam produced by the wobbling system through the polyethylene plate phantom. The results of TLD measurement were compared to the Monte Carlo simulation. Results: The initial experiment results of calculated dose equivalents are 0.63, 0.38, 0.21 and 0.13 mSv per Gy outside the field at the distance of 50, 100, 150 and 200 cm. Conclusion: The TLD-600 and TLD-700 pairs are convenient to estimate neutron and gamma dosimetry during proton therapy. However, an accurate and suitable glow curve analysis technique is necessary. During the wobbling system proton therapy, our results showed that the neutron and gamma doses outside the treatment field are noticeable. This study was supported by the grants from the Chang Gung Memorial Hospital (CMRPD1C0682)

61 RADIATION PROTECTION AND DOSIMETRY↗