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SU-E-T-377: Evaluation of a Novel Transmission Detector as a Reference Chamber for Use in Beam Measurements

Purpose: To evaluate a new transmission chamber for use as a reference chamber in measurements of beam data Methods: We assessed the performance of a new transmission detector, the Stealth Chamber, manufactured by IBA (IBA Dosimetry). The chamber has an active volume of 249 cm{sup 3}, with an attenuation equivalent of <0.5mm Al. We mounted the chamber to a TrueBeam linac (Varian Medical Systems, Palo Alto, CA) such that the active area is perpendicular to the beam direction. We performed PDD and profile measurements on field sizes from 1×1 cm{sup 2} to 10×10 cm{sup 2}, as well as for a 4 mm cone. The field detector was either a CC-13 chamber (IBA Dosimetry) with an active volume of 0.13 cm{sup 3} or an Edge Detector (Sun Nuclear, Melbourne, FL) with an active volume of 0.019 cm{sup 3}. For comparison we repeated all measurements using a CC-13 or CC-01 (active volume 0.01 cm{sup 3} ) chamber as reference detectors (IBA Dosimetry).All scans were acquired using a Blue Phantom2 (IBA Dosimetry) and IBA OmniPro-Accept v7.4.24 software. Results: All measurements with the Stealth Chamber were identical to those with ion reference chambers. For both regular and filter free 6MV beams there was agreement in PDDs and profiles, including the penumbra region, for all field sizes. This was true for the 4mm cone measurement, as well. The deviation between the Stealth and ion chamber measurements was on average 0.3%. Conclusion: The Stealth Chamber gives identical beam data as a conventional ion chamber for all field sizes. The advantage of the Stealth chamber over ion chambers is its efficiency. Once mounted, there is no need to reposition the chamber with varying field sizes. This translates into a huge savings in measurement time, as well as a reduction in potential errors due to reference chamber mispositioning.

43 PARTICLE ACCELERATORS↗

A neutron fluence map of the Los Alamos National Laboratory Godiva IV critical assembly

A neutron fluence map and a total ionizing dose map of the Los Alamos National Laboratory Godiva IV fast burst critical assembly was generated using passive reactor dosimetry, comprised of sulfur pellets and thermoluminescent dosimeters. Godiva IV is an unmoderated, fast burst, critical assembly constructed of approximately 65 kg of highly enriched uranium fuel alloyed with 1.5 % molybdenum for strength. The mapping was performed during a single 75.6 ºC temperature rise burst operation, with the top and sides of the cylindrical Godiva-IV Top Hat covered in passive dosimetry. Dosimetry was placed in a symmetric pattern around the Top Hat, with higher concentrations near the control rods and burst rod. A specific portion of the lower quadrant of the burst rod was mapped to confirm a testing region where the neutron fluence varied by no more than ± 5%. The results will be used to assess the neutron, gamma, and total ionizing dose environment in three-dimensional space around the assembly for higher fidelity experiment placement, active dosimetry positioning, and radiation field characterization.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Evaluation of the Pool Critical Assembly Benchmark with Explicitly-Modeled Geometry using MCNP6

Despite being one of the most widely used benchmarks for qualifying light water reactor (LWR) radiation transport methods and data, no benchmark calculation of the Oak Ridge National Laboratory (ORNL) Pool Critical Assembly (PCA) pressure vessel wall benchmark facility (PVWBF) using MCNP6 with explicitly modeled core geometry exists. As such, this paper provides results for such an analysis. First, a criticality calculation is used to construct the fixed source term. Next, ADVANTG-generated variance reduction parameters are used within the final MCNP6 fixed source calculations. These calculations provide unadjusted dosimetry results using three sets of dosimetry reaction cross sections of varying ages (those packaged with MCNP6, from the IRDF-2002 multi-group library, and from the ACE-formatted IRDFF v1.05 library). These results are then compared to two different sets of measured reaction rates. The comparison agrees in an overall sense within 2% and on a specific reaction- and dosimetry location-basis within 5%. Except for the neptunium dosimetry, the individual foil raw calculation-to-experiment comparisons usually agree within 10% but is typically greater than unity. Finally, in the course of developing these calculations, geometry that has previously not been completely specified is provided herein for the convenience of future analysts.

22 GENERAL STUDIES OF NUCLEAR REACTORS↗

MO-D-BRD-01: Memorial to Bengt Bjarngard - Memorial Lecture

We lost a legendary medical physicist, Dr. Bengt Erik Bjarngard, to angiosarcoma an aggressive type of cancer. He devoted his life to providing improved methods of radiation treatment for this devastating disease over the last 36 years. Bengt was born in a rural village of Bjarnum in southern Sweden, located near forest and is known for its furniture making. He migrated to USA at the age of 35 and was recruited by Dr. Samuel Hellman to lead a group of physicists that became the “mecca of medical physics” known as the Joint Center of Radiation Therapy (JCRT) at Harvard Medical School in Boston. Bengt mentored some of the best physicists in the country, and many of our modern treatments go back to the early days of research at the JCRT. These accomplishments, dating from 1969–1989, include: dose optimization using computer control; soft wedges; stereotactic radiosurgery (SRS); total-body irradiation (TBI); CT-planning; and radiation dosimetry. Bengt worked at Brown University in Rhode Island and at the University of Pennsylvania in Philadelphia, where he provided major contributions in radiation dosimetry, specifically with the head scatter model. He advocated superior calculation algorithm through the Helax treatment planning system that was on par from most commercial systems. Bengt served as AAPM president in 1979 and was a recipient of the Coolidge Award in 1998. He had a lifelong love of nature, retiring in 2000 from the University of Pennsylvania to take care of his 200 acres of homestead forest in Maine. His legacy continues through his contributions to radiation dosimetry. This session, on small field dosimetry, is a small tribute to his memory. Further details can be found in his obituary in Med Phy, 41(4), 040801, 2014.

60 APPLIED LIFE SCIENCES↗

MO-F-16A-06: Implementation of a Radiation Exposure Monitoring System for Surveillance of Multi-Modality Radiation Dose Data

Purpose: We have implemented a commercially available Radiation Exposure Monitoring System (REMS) to enhance the processes of radiation dose data collection, analysis and alerting developed over the past decade at our sites of practice. REMS allows for consolidation of multiple radiation dose information sources and quicker alerting than previously developed processes. Methods: Thirty-nine x-ray producing imaging modalities were interfaced with the REMS: thirteen computed tomography scanners, sixteen angiography/interventional systems, nine digital radiography systems and one mammography system. A number of methodologies were used to provide dose data to the REMS: Modality Performed Procedure Step (MPPS) messages, DICOM Radiation Dose Structured Reports (RDSR), and DICOM header information. Once interfaced, the dosimetry information from each device underwent validation (first 15–20 exams) before release for viewing by end-users: physicians, medical physicists, technologists and administrators. Results: Before REMS, our diagnostic physics group pulled dosimetry data from seven disparate databases throughout the radiology, radiation oncology, cardiology, electrophysiology, anesthesiology/pain management and vascular surgery departments at two major medical centers and four associated outpatient clinics. With the REMS implementation, we now have one authoritative source of dose information for alerting, longitudinal analysis, dashboard/graphics generation and benchmarking. REMS provides immediate automatic dose alerts utilizing thresholds calculated through daily statistical analysis. This has streamlined our Closing the Loop process for estimated skin exposures in excess of our institutional specific substantial radiation dose level which relied on technologist notification of the diagnostic physics group and daily report from the radiology information system (RIS). REMS also automatically calculates the CT size-specific dose estimate (SSDE) as well as provides two-dimensional angulation dose maps for angiography/interventional procedures. Conclusion: REMS implementation has streamlined and consolidated the dosimetry data collection and analysis process at our institutions while eliminating manual entry error and providing immediate alerting and access to dosimetry data to both physicists and physicians. Brent Stewart has funded research through GE Healthcare.

60 APPLIED LIFE SCIENCES↗

Workforce and Salary Survey Trends: Opportunities and Challenges for the American Association of Medical Dosimetrists

The American Association of Medical Dosimetrists (AAMD) designed and directed 2 surveys of the AAMD membership. The first was in 2011 and the second in 2014. There were a number of questions common to both surveys, and this article seeks to evaluate these common questions to determine trends among the professional membership of the AAMD. It is demonstrated that the observed trends are consistent with the goals and objectives established by the leadership of the AAMD and the Medical Dosimetry Certification Board (MDCB) for the medical dosimetry community. In addition, certain challenges and opportunities involving the scope of practice for the medical dosimetry profession are discussed.

61 RADIATION PROTECTION AND DOSIMETRY↗

A Review of the Resuspension of Radioactively Contaminated Particles by Vehicle and Pedestrian Traffic—Current Theory, Practice, Gaps, and Needs

Here, the resuspension of radioactively contaminated particles in a built environment, such as from urban surfaces like foliage, building exteriors, and roadways, is described empirically by current plume and dosimetry models used for hazard assessment and long-term risk purposes. When applying these models to radiological contamination emergencies affecting urban areas, the accuracy of the results for recent contamination deposition is impacted in two main ways. First, the data supporting the underlying resuspension equations was acquired for open, quiescent conditions with no vehicle traffic or human activities, so it is not necessarily representative of the urban environment. Second, mechanical disturbance by winds in urban canyons and during emergency operations caused by vehicle traffic and human activities are not directly considered by the equations. Accordingly, plume and dosimetry models allow the user to input certain compensating values, but the models do not necessarily supply users instructions on what values to use. This manuscript reviews the available literature to comprehensively and consistently pool data for resuspension due to mechanically induced resuspension applicable to urban contamination. Because there are few studies that directly measured radioactive resuspension due to vehicles and pedestrians, this review novelly draws on a range of other studies involving non-radioactive particles, ranging from outdoor air pollution emissions to indoor allergen transport. The results lead to tabulated, recommended values for specific conditions in the emergency phase to help users of plume and dosimetry models maintain the conservativeness needed to properly capture the potential radiation dose posed by mechanically induced resuspension. These values are of benefit to model users until better data are available. The results also suggest the types of data that may result in improved plume and dose modeling.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-E-T-93: Activation of Psoralen at Depth Using Kilovoltage X-Rays: Physics Considerations in Implementing a New Teletherapy Paradigm

Purpose: Psoralen is a UV-light activated anti-cancer biotherapeutic used for treating skin lesions (PUVA) and advanced cutaneous T-cell lymphoma (ECP). To date psoralen has not been used to treat deep seated tumors due to difficulty in generating UV-light at depth. We recently demonstrated psoralen activation at depth by introducing energy converting particles that absorb kV x-ray radiation and re-emit UV-light. Our in-vitro work found that 0.2–1Gy using 40–100kVp x-rays combined with psoralen and particles can induce a substantial apoptotic response beyond that expected from the sum of individual components. In preparation for a phase I clinical trial of canine companion animals, we address the physics and dosimetry considerations for applying this new teletherapy paradigm to an in-vivo setting. Methods: The kV on-board imaging (OBI) system mounted on a medical linear accelerator (Varian) was commissioned to deliver the prescribed dose (0.6Gy) using 80 and 100kVp. Dosimetric measurements included kVp, HVL, depth dose, backscatter factors, collimator and phantom scatter factors, field size factors, and blade leakage. Absolute dosimetry was performed following AAPM TG61 recommendations and verified with an independent kV dose meter. We also investigated collimated rotational delivery to minimize skin dose using simple dose calculations on homogeneous cylindrical phantoms. Results: Single beam delivery is feasible for shallow targets (<5cm) without exceeding skin tolerance, while a rotational delivery may be utilized for deeper targets; skin dose is ∼75% of target dose for 80kVp collimated rotational delivery to a 3cm target within a 20cm phantom. Heat loading was tolerable; 0.6Gy to 5cm can be delivered before the anode reaches 75% capacity. Conclusion: KV teletherapy for Psoralen activation in deep seated tissue was successfully commissioned for a Varian OBI machine for use in a phase I clinical trial in canines. Future work will use Monte Carlo dosimetry to investigate dose in presence of bone. Research funded by Immunolight LLC. H. Walder, Z. Fathi, & W. Beyer are employees of Immunolight LLC which holds a patent on the technology. Drs. Adamson and Oldham are consultants to Immunolight LLC.

60 APPLIED LIFE SCIENCES↗

SU-E-T-163: Characterization of a Novel High Resolution 1D Silicon Monolithic Array for Small Field Commissioning and Quality Assurance

Purpose: To study the suitability of a novel 1D silicon monolithic array for dosimetry of small radiation fields and for QA of high dose gradient treatment modalities (IMRT and SBRT). Methods: A 1D array composed of 4 monolithic silicon modules of 64 mm length and 1 mm pixel pitch was developed by IBA Dosimetry. Measurements were carried out for 6MV and 15MV photons on two commercial different linacs (TrueBeam and Clinac iX, Varian Medical Systems, Palo Alto, CA) and for a CyberKnife G4 (Accuray Inc., Sunnyvale, CA). The 1D array was used to measure output factors (OF), profiles and off axis correction factors (OACF) for the Iris CyberKnife variable collimator (5–60 mm). In addition, dose profiles (at the isocenter plane) were measured for multiple IMRT and SBRT treatment plans and compared with those obtained using EDR2radiographic film (Carestream Health, Rochester NY), a commercial 2D diode array and with the dose distribution calculated using a commercial TPS (Eclipse, Varian Medical Systems, Palo Alto, CA). Results: Due to the small pixel pitch of the detector, IMRT and SBRT plan profiles deviate from film measurements by less than 2%. Similarly, the 1D array exhibits better performance than the 2D diode array due to the larger (7 mm) pitch of that device. Iris collimator OFs measured using the 1D silicon array are in good agreement with the commissioning values obtained using a commercial stereotactic diode as well as with published data. Maximum deviations are < 3% for the smallest field (5 and 7.5mm) and below 1% for all other dimensions. Conclusion: We have demonstrated good performances of the array for commissioning of small photon fields and in patient QA, compared with diodes and film typically used in these clinical applications. The technology compares favorably with existing commercial solutions The presenting author is founded by a Marie Curie Early Initial Training Network Fellowship of the European Communitys Seventh Framework Programme under contract number (PITN-GA-2011-289198-ARDENT). The research activity is hosted by IBA Dosimetry, Gmbh.

60 APPLIED LIFE SCIENCES↗

SU-E-T-231: Cross-Validation of 3D Gamma Comparison Tools

Purpose: Moving the computational analysis for 3D gel dosimetry into the 3D Slicer (www.slicer.org) environment has made gel dosimetry more clinically accessible. To ensure accuracy, we cross-validate the 3D gamma comparison module in 3D Slicer with an independently developed algorithm using simulated and measured dose distributions. Methods: Two reference dose distributions were generated using the Varian Eclipse treatment planning system. The first distribution consisted of a four-field box irradiation delivered to a plastic water phantom and the second, a VMAT plan delivered to a gel dosimeter phantom. The first reference distribution was modified within Eclipse to create an evaluated dose distribution by spatially shifting one field by 3mm, increasing the monitor units of the second field, applying a dynamic wedge for the third field, and leaving the fourth field unchanged. The VMAT plan was delivered to a gel dosimeter and the evaluated dose in the gel was calculated from optical CT measurements. Results from the gamma comparison tool built into the SlicerRT toolbox were compared to results from our in-house gamma algorithm implemented in Matlab (via MatlabBridge in 3D Slicer). The effects of noise, resolution and the exchange of reference and evaluated designations on the gamma comparison were also examined. Results: Perfect agreement was found between the gamma results obtained using the SlicerRT tool and our Matlab implementation for both the four-field box and gel datasets. The behaviour of the SlicerRT comparison with respect to changes in noise, resolution and the role of the reference and evaluated dose distributions was consistent with previous findings. Conclusion: Two independently developed gamma comparison tools have been cross-validated and found to be identical. As we transition our gel dosimetry analysis from Matlab to 3D Slicer, this validation serves as an important test towards ensuring the consistency of dose comparisons using the 3D Slicer environment.

60 APPLIED LIFE SCIENCES↗

SU-E-T-286: Dose Verification of Spot-Scanning Proton Beam Using GafChromic EBT3 Film

Purpose: Dose verification of spot-scanning proton pencil beam is performed via planar dose measurements at several depths using an ionization-chamber array, requiring repeat irradiations of each field for each depth. Here we investigate film dosimetry which has two advantages: higher resolution and efficiency from one-shot irradiation for multiple depths. Methods: Film calibration was performed using an EBT3 film at 20-cm depth of Plastic Water (CIRS, Norfolk, VA) exposed by a 10-level step wedge on a Proteus Plus proton system (IBA, Belgium). The calibration doses ranged from 25–250 cGy(RBE) for proton energies of 170–200 MeV. A uniform 1000 cm{sup 3} dose cube and a clinical prostate combined with seminal-vesicle and pelvic-nodes plan were used for this study. All treatment plans were generated in the RayStation (RaySearch Lab, Sweden). The planar doses at different depths for both cases were measured with film using triple-channel dosimetry and the MatriXX PT (IBA Dosimetry, Germany). The Gamma passing rates, dose-difference maps, and profiles of 2D planar doses measured with EBT3 film and MatriXX, versus treatment planning system (TPS) calculations were analyzed and compared using the FilmQA Pro (Ashland Inc., Bridgewater, NJ). Results: The EBT3 film measurement results matched well with the TPS calculation data with an average passing rate >95% for 2%/2mm and are comparable with the MatriXX measurements (0.7%, 1.8%, 3.8% mean differences corresponding to 3%/3mm, 3%/2mm, 2%/2mm, respectively). Overall passing rates for EBT3 films appear higher than those with MatriXX detectors. Conclusion: The energy dependence of the film response could be minimized by calibration using proton beam with mixed energies. The greater efficiency of the dose verification using GafChromic EBT3 results in a potential cost trade-off between room capacity and film cost. EBT3 film may offer distinct advantages in highly intensity-modulated fields due to its higher resolution compared to 2D ionization-chamber array detectors. One of the authors has a research grant from Ashland Inc., the manufacturer of GafChromic film.

60 APPLIED LIFE SCIENCES↗

SU-E-T-301: Dosimetric Comparison Between Adaptive and Rectilinear Template-Based Prostate Seed Implants

Purpose: To compare the dosimetry of a standard rectilinear and an adaptive technique used in I125 prostate seed implants. Methods: To achieve favorable dosimetry in prostate implants we used adaptive needle updates to match actual positions in real-time. The seed locations were optimized based on actual needle locations. The seeds were delivered automatically with a robotic device seedSelectron™ (Elekta Brachytherapy). In this study, we evaluated the former approach against the standard rectilinear technique in which the needles have a parallel distribution. The treatment plans for 10 patients were analyzed. For comparison, the actual treatment plans were revised so each needle was repositioned to its original parallel location through the template. The analysis was performed by comparing the target coverage and dose to the organs at risk. The comparison was done using the following planning goals: the target D90> 90%, V100% > 90%, V50% <70% and V200% <30%; the urethra V125% < 1cm3 and V150%= 0cm3; and the Rectum V100%<1cm3 and V69% < 8cm3. The prescription dose to the target was 145Gy. Results: The average target volume and number of seeds were 44.39cm3(SD=11.14) and 74(SD=12), respectively. The D90 for adaptive and rectilinear plans was 159.9Gy(SD=2.99) and 155.53Gy(SD=4.04) resulting in a 2.74% difference for the average target coverage. A similar difference (1.75%) was noticed in the target V100[%]. No significant difference was noticed in the dose to the urethra and rectum. All planning goals were met with both the adaptive and rectilinear approach for each plan. Conclusion: The study reveals enhanced coverage of the target when using the adaptive needle adjustments as compared to the rectilinear approach for the analyzed cases. However, the differences in dosimetry did not translate to meaningful clinical outcomes.

60 APPLIED LIFE SCIENCES↗

SU-E-T-582: On-Line Dosimetric Verification of Respiratory Gated Volumetric Modulated Arc Therapy Using the Electronic Portal Imaging Device

Purpose: To investigate the clinical utility of on-line verification of respiratory gated VMAT dosimetry during treatment. Methods: Portal dose images were acquired during treatment in integrated mode on a Varian TrueBeam (v. 1.6) linear accelerator for gated lung and liver patients that used flattening filtered beams. The source to imager distance (SID) was set to 160 cm to ensure imager clearance in case the isocenter was off midline. Note that acquisition of integrated images resulted in no extra dose to the patient. Fraction 1 was taken as baseline and all portal dose images were compared to that of the baseline, where the gamma comparison and dose difference were used to measure day-to-day exit dose variation. All images were analyzed in the Portal Dosimetry module of Aria (v. 10). The portal imager on the TrueBeam was calibrated by following the instructions for dosimetry calibration in service mode, where we define 1 calibrated unit (CU) equal to 1 Gy for 10×10 cm field size at 100 cm SID. This reference condition was measured frequently to verify imager calibration. Results: The gamma value (3%, 3 mm, 5% threshold) ranged between 92% and 100% for the lung and liver cases studied. The exit dose can vary by as much as 10% of the maximum dose for an individual fraction. The integrated images combined with the information given by the corresponding on-line soft tissue matched cone-beam computed tomography (CBCT) images were useful in explaining dose variation. For gated lung treatment, dose variation was mainly due to the diaphragm position. For gated liver treatment, the dose variation was due to both diaphragm position and weight loss. Conclusion: Integrated images can be useful in verifying dose delivery consistency during respiratory gated VMAT, although the CBCT information is needed to explain dose differences due to anatomical changes.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-F-BRA-06: Dose Distributions for the CivaSheet Pd-103 Directional Brachytherapy Device

Purpose: A flexible polymer membrane (CivaSheet) has been developed by CivaTech Oncology, Inc. (Research Triangle Park, NC) for permanent brachytherapy. Distributed throughout the array are small plastic disks containing Pd-103 and gold foil shielding on one side to provide a directional dose distribution and facilitate imaging. This study evaluated dosimetry for the CivaSheet. Methods: Manufacturer-provided dimensional and compositional information for the device were compared to physical samples for validation of design information, then entered into the MCNP6 radiation transport code for dosimetry simulations. Three device sizes (6×6, 6×12, or 6×18 disk-arrays) were simulated as the membrane can be custom-sized preceding surgical placement. Dose to water was estimated with 0.01 cm resolution from the surface to 10 cm on both sides of the device. Because this is a novel device with calibration methods under development, results were normalized using DVHs to provide 90% prescription coverage to a plane positioned 0.5 cm from the front surfaces. This same normalization was used for creating isodose distributions. Results: Planar dose distributions of flat CivaSheets were relatively homogeneous with acceptable dose uniformity variations. Differences in the results between the differently sized CivaSheets were not significant. At 0.5 mm, 87% of the target volume was within the therapeutic dose range. Dose hotspots on the CivaSheet forward surfaces were directly above the disks. However, dose hotspots on the rear-facing surfaces were positioned between the disks. Doses in contact with the front surface were similar to those observed for currently available brachytherapy sources. Maximum doses that occurred on the rear surface were approximately 55 times lower than the dose on the front surface. Conclusion: Monte Carlo calculations validated the directional capabilities and advantageous dosimetry of the new Pd-103 brachytherapy device. It appears feasible to re-size the CivaSheet in the operating room with an acceptable variation in prescription dose. Research was supported by CivaTech Oncology, Inc.

60 APPLIED LIFE SCIENCES↗

MO-A-BRD-01: Clinical Perspective

Yttrium-90 (Y90) microsphere therapy, a form of radiation therapy, is an increasingly popular option for care of patients with liver metastases or unresectable hepatocellular carcinoma. The therapy directly delivers Y90 microspheres via the hepatic artery to disease sites. Following delivery, a vast majority of microspheres preferentially lodge in the capillary vessels due to their embolic size and targeted trans-arterial delivery – depositing up to 90% of its energy in the first 5 mm of tissue. There have been a number of advances in tomographic imaging within both interventional radiology and nuclear medicine that has advanced therapy planning techniques. Quantitative imaging of Y90 microsphere distribution post-therapy has also seen innovations that have led to improvements in tumor dosimetry and characterization of tumor response. A review of current trends and recent innovation in Y90 microsphere therapies will be presented. Learning Objectives: To present the imaging requirements for Y90 microsphere therapy planning To explain the standard dosimetry models used in Y90 microsphere therapy planning To report on advances in imaging for therapy planning and posttherapy assessment of tumor dosimetry and response.

60 APPLIED LIFE SCIENCES↗

MO-A-BRD-02: Physics Perspective

Yttrium-90 (Y90) microsphere therapy, a form of radiation therapy, is an increasingly popular option for care of patients with liver metastases or unresectable hepatocellular carcinoma. The therapy directly delivers Y90 microspheres via the hepatic artery to disease sites. Following delivery, a vast majority of microspheres preferentially lodge in the capillary vessels due to their embolic size and targeted trans-arterial delivery – depositing up to 90% of its energy in the first 5 mm of tissue. There have been a number of advances in tomographic imaging within both interventional radiology and nuclear medicine that has advanced therapy planning techniques. Quantitative imaging of Y90 microsphere distribution post-therapy has also seen innovations that have led to improvements in tumor dosimetry and characterization of tumor response. A review of current trends and recent innovation in Y90 microsphere therapies will be presented. Learning Objectives: To present the imaging requirements for Y90 microsphere therapy planning To explain the standard dosimetry models used in Y90 microsphere therapy planning To report on advances in imaging for therapy planning and posttherapy assessment of tumor dosimetry and response.

60 APPLIED LIFE SCIENCES↗

WE-F-201-00: Practical Guidelines for Commissioning Advanced Brachytherapy Dose Calculation Algorithms

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗

WE-F-201-01: Identify Key Clinical Applications Needing Advanced Dose Calculation in Brachytherapy

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. A charge of the AAPM-ESTRO-ABG Working Group on MBDCA in Brachytherapy (WGMBDCA) is the development of a set of well-defined test case plans, available as references in the software commissioning process to be performed by clinical end-users. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG-43 and heterogeneity-based dosimetry. Learning Objectives: Identify key clinical applications needing advanced dose calculation in brachytherapy. Review TG-186 and WGMBDCA guidelines, commission process, and dosimetry benchmarks. Evaluate clinical cases using commercially available systems and compare to TG-43 dosimetry.

60 APPLIED LIFE SCIENCES↗