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At least 91 records · Page 5
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DOE OSTI2014

High energy x-ray phase contrast CT using glancing-angle grating interferometers

Purpose: The authors present initial progress toward a clinically compatible x-ray phase contrast CT system, using glancing-angle x-ray grating interferometry to provide high contrast soft tissue images at estimated by computer simulation dose levels comparable to conventional absorption based CT. Methods: DPC-CT scans of a joint phantom and of soft tissues were performed in order to answer several important questions from a clinical setup point of view. A comparison between high and low fringe visibility systems is presented. The standard phase stepping method was compared with sliding window interlaced scanning. Using estimated dose values obtained with a Monte-Carlo code the authors studied the dependence of the phase image contrast on exposure time and dose. Results: Using a glancing angle interferometer at high x-ray energy (∼45 keV mean value) in combination with a conventional x-ray tube the authors achieved fringe visibility values of nearly 50%, never reported before. High fringe visibility is shown to be an indispensable parameter for a potential clinical scanner. Sliding window interlaced scanning proved to have higher SNRs and CNRs in a region of interest and to also be a crucial part of a low dose CT system. DPC-CT images of a soft tissue phantom at exposures in the range typical for absorption based CT of musculoskeletal extremities were obtained. Assuming a human knee as the CT target, good soft tissue phase contrast could be obtained at an estimated absorbed dose level around 8 mGy, similar to conventional CT. Conclusions: DPC-CT with glancing-angle interferometers provides improved soft tissue contrast over absorption CT even at clinically compatible dose levels (estimated by a Monte-Carlo computer simulation). Further steps in image processing, data reconstruction, and spectral matching could make the technique fully clinically compatible. Nevertheless, due to its increased scan time and complexity the technique should be thought of not as replacing, but as complimentary to conventional CT, to be used in specific applications.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

TU-A-BRF-01: MR Guided Radiation Therapy

In recent years, there has been an increasing interest in the development of new technologies focused on the deeper integration of MR in radiotherapy. The innovations span from image data acquisition and post-processing to clinical implementation of MR-guided RT systems and workflow development. The session is intended to provide a review of the key and most recent advancements. Targeted discussions will cover topics which currently define the concept of MR-guided radiotherapy including a) system commissioning, quality control and safety, b) MR data manipulation for dose computations and treatment simulation, c) quantification/management of organ motion and treatment delivery guidance. Learning Objectives: Understand the concept and specifics of MR-guided radiotherapy; Understand the requirements for system integration in clinical workflow; Become familiar with the proposed strategies for system commissioning, RT planning and delivery guidance.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2011

Extraction of tumor motion trajectories using PICCS-4DCBCT: A validation study

Purpose: As a counterpart of 4DCT in the treatment planning stage of radiotherapy treatment, 4D cone beam computed tomography (4DCBCT) method has been proposed to verify tumor motion trajectories before radiation therapy treatment delivery. Besides 4DCBCT acquisition using slower gantry rotation speed or multiple rotations, a new method using the prior image constrained compressed sensing (PICCS) image reconstruction method and the standard 1-min data acquisition were proposed. In this paper, the PICCS-4DCBCT method was combined with deformable registration to validate its capability in motion trajectory extraction using physical phantom data, simulated human subject data from 4DCT and in vivo human subject data. Methods: Two methods were used to validate PICCS-4DCBCT for the purpose of respiratory motion delineation. The standard 1-min gantry rotation Cone Beam CT acquisition was used for both methods. In the first method, 4DCBCT projection data of a physical motion phantom were acquired using an on-board CBCT acquisition system (Varian Medical Systems, Palo Alto, CA). Using a deformable registration method, the object motion trajectories were extracted from both FBP and PICCS reconstructed 4DCBCT images, and compared against the programmed motion trajectories. In the second method, using a clinical 4DCT dataset, Cone Beam CT projections were simulated by forward projection. Using a deformable registration method, the tumor motion trajectories were extracted from the reconstructed 4DCT and PICCS-4DCBCT images. The performance of PICCS-4DCBCT is assessed against the 4DCT ground truth. The breathing period was varied in the simulation to study its effect on motion extraction. For both validation methods, the root mean square error (RMSE) and the maximum of the errors (MaxE) were used to quantify the accuracy of the extracted motion trajectories. After the validation, a clinical dataset was used to demonstrate the motion delineation capability of PICCS-4DCBCT for human subjects. Results: In both validation studies, the RMSEs of the extracted motion trajectories from PICCS-4DCBCT images are less than 0.7 mm, and their MaxEs are less than 1 mm, for all three directions. In comparison, FBP-4DCBCT shows considerably larger RMSEs in the physical phantom based validation. PICCS-4DCBCT also shows insensitivity to the breathing period in the 4DCT based validation. For the in vivo human subject study, high quality 3D motion trajectory of the tumor was obtained from PICCS-4DCBCT images and showed consistency with visual observation. Conclusions: These results demonstrate accurate delineation of tumor motion trajectory can be achieved using PICCS-4DCBCT and the standard 1-min data acquisition.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2012

Mapping of RBE-Weighted Doses Between HIMAC- and LEM-Based Treatment Planning Systems for Carbon Ion Therapy

Purpose: A method was developed to convert clinically prescribed RBE (Relative Biological Effectiveness)-weighted doses from the approach used at the Heavy-Ion Medical Accelerator (HIMAC) at the National Institute of Radiological Science, Chiba, Japan, to the LEM (Local Effect Model)-based TReatment planning for Particles (TRiP98) approach used in the pilot project at the GSI Helmholtzzentrum, Darmstadt, and the Heidelberg Ion-Beam Therapy Center (HIT). Methods and Materials: The proposed conversion method is based on a simulation of the fixed spread-out Bragg peak (SOBP) depth dose profiles as used for the irradiation at HIMAC by LEM/TRiP98 and a recalculation of the resulting RBE-weighted dose distribution. We present data according to the clinical studies conducted at GSI in the past decade (LEM I), as well as data used in current studies (refined LEM version: LEM IV). Results: We found conversion factors (RBE-weighted dose LEM/RBE-weighted dose HIMAC) reaching from 0.4 to 2.0 for prescribed carbon ion doses from 1 to 60 Gy (RBE) for SOBP extensions ranging from 20 to 120 mm according to the HIMAC approach. A conversion factor of 1.0 was found for approximately 5 Gy (RBE). The conversion factor decreases with increasing prescribed dose. Slightly smaller values for the LEM IV-based data set compared with LEM I were found. A significant dependence of the conversion factor from the SOBP width could be observed in particular for LEM IV, whereas the depth dependence was found to be small. Conclusions: For the interpretation and comparison of clinical trials performed at HIMAC and GSI/HIT, it is of extreme importance to consider these conversion factors because according to the various methods to determine the RBE-weighted dose, similar dose values might not necessarily be related to similar clinical outcomes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

SU-E-J-115: Using Markov Chain Modeling to Elucidate Patterns in Breast Cancer Metastasis Over Time and Space

Purpose: Traditionally, breast cancer metastasis is described as a process wherein cancer cells spread from the breast to multiple organ systems via hematogenous and lymphatic routes. Mapping organ specific patterns of cancer spread over time is essential to understanding metastatic progression. In order to better predict sites of metastases, here we demonstrate modeling of the patterned migration of metastasis. Methods: We reviewed the clinical history of 453 breast cancer patients from Memorial Sloan Kettering Cancer Center who were non-metastatic at diagnosis but developed metastasis over time. We used the variables of organ site of metastases as well as time to create a Markov chain model of metastasis. We illustrate the probabilities of metastasis occurring at a given anatomic site together with the probability of spread to additional sites. Results: Based on the clinical histories of 453 breast cancer patients who developed metastasis, we have learned (i) how to create the Markov transition matrix governing the probabilities of cancer progression from site to site; (ii) how to create a systemic network diagram governing disease progression modeled as a random walk on a directed graph; (iii) how to classify metastatic sites as ‘sponges’ that tend to only receive cancer cells or ‘spreaders’ that receive and release them; (iv) how to model the time-scales of disease progression as a Weibull probability distribution function; (v) how to perform Monte Carlo simulations of disease progression; and (vi) how to interpret disease progression as an entropy-increasing stochastic process. Conclusion: Based on our modeling, metastatic spread may follow predictable pathways. Mapping metastasis not simply by organ site, but by function as either a ‘spreader’ or ‘sponge’ fundamentally reframes our understanding of metastatic processes. This model serves as a novel platform from which we may integrate the evolving genomic landscape that drives cancer metastasis. PS-OC Trans-Network Project Grant Award for “Data Assimilation and ensemble statistical forecasting methods applied to the MSKCC longitudinal metastatic breast cancer cohort.”.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2021

Using Auto-Segmentation to Reduce Contouring and Dose Inconsistency in Clinical Trials: The Simulated Impact on RTOG 0617

Contouring inconsistencies are known but understudied in clinical radiation therapy trials. We applied auto-contouring to the Radiation Therapy Oncology Group (RTOG) 0617 dose escalation trial data. We hypothesized that the trial heart doses were higher than reported due to inconsistent and insufficient heart segmentation. We tested our hypothesis by comparing doses between deep-learning (DL) segmented hearts and trial hearts.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Dimensionality and noise in energy selective x-ray imaging

Purpose: To develop and test a method to quantify the effect of dimensionality on the noise in energy selective x-ray imaging.Methods: The Cramèr-Rao lower bound (CRLB), a universal lower limit of the covariance of any unbiased estimator, is used to quantify the noise. It is shown that increasing dimensionality always increases, or at best leaves the same, the variance. An analytic formula for the increase in variance in an energy selective x-ray system is derived. The formula is used to gain insight into the dependence of the increase in variance on the properties of the additional basis functions, the measurement noise covariance, and the source spectrum. The formula is also used with computer simulations to quantify the dependence of the additional variance on these factors. Simulated images of an object with three materials are used to demonstrate the trade-off of increased information with dimensionality and noise. The images are computed from energy selective data with a maximum likelihood estimator.Results: The increase in variance depends most importantly on the dimension and on the properties of the additional basis functions. With the attenuation coefficients of cortical bone, soft tissue, and adipose tissue as the basis functions, the increase in variance of the bone component from two to three dimensions is 1.4 × 10{sup 3}. With the soft tissue component, it is 2.7 × 10{sup 4}. If the attenuation coefficient of a high atomic number contrast agent is used as the third basis function, there is only a slight increase in the variance from two to three basis functions, 1.03 and 7.4 for the bone and soft tissue components, respectively. The changes in spectrum shape with beam hardening also have a substantial effect. They increase the variance by a factor of approximately 200 for the bone component and 220 for the soft tissue component as the soft tissue object thickness increases from 1 to 30 cm. Decreasing the energy resolution of the detectors increases the variance of the bone component markedly with three dimension processing, approximately a factor of 25 as the resolution decreases from 100 to 3 bins. The increase with two dimension processing for adipose tissue is a factor of two and with the contrast agent as the third material for two or three dimensions is also a factor of two for both components. The simulated images show that a maximum likelihood estimator can be used to process energy selective x-ray data to produce images with noise close to the CRLB.Conclusions: The method presented can be used to compute the effects of the object attenuation coefficients and the x-ray system properties on the relationship of dimensionality and noise in energy selective x-ray imaging systems.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Scatter factors assessment in microbeam radiation therapy

Purpose: The success of the preclinical studies in Microbeam Radiation Therapy (MRT) paved the way to the clinical trials under preparation at the Biomedical Beamline of the European Synchrotron Radiation Facility. Within this framework, an accurate determination of the deposited dose is crucial. With that aim, the scatter factors, which translate the absolute dose measured in reference conditions (2 x 2 cm{sup 2} field size at 2 cm-depth in water) to peak doses, were assessed. Methods: Monte Carlo (MC) simulations were performed with two different widely used codes, PENELOPE and GEANT4, for the sake of safety. The scatter factors were obtained as the ratio of the doses that are deposited by a microbeam and by a field of reference size, at the reference depth. The calculated values were compared with the experimental data obtained by radiochromic (ISP HD-810) films and a PTW 34070 large area chamber. Results: The scatter factors for different microbeam field sizes assessed by the two MC codes were in agreement and reproduced the experimental data within uncertainty bars. Those correction factors were shown to be non-negligible for the future MRT clinical settings: an average 30% lower dose was deposited by a 50 {mu}m microbeam with respect to the reference conditions. Conclusions: For the first time, the scatter factors in MRT were systematically studied. They constitute an essential key to deposit accurate doses in the forthcoming clinical trials in MRT. The good agreement between the different calculations and the experimental data confirms the reliability of this challenging micrometric dose estimation.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Monte Carlo calculations for reference dosimetry of electron beams with the PTW Roos and NE2571 ion chambers

Purpose: To investigate recommendations for reference dosimetry of electron beams and gradient effects for the NE2571 chamber and to provide beam quality conversion factors using Monte Carlo simulations of the PTW Roos and NE2571 ion chambers. Methods: The EGSnrc code system is used to calculate the absorbed dose-to-water and the dose to the gas in fully modeled ion chambers as a function of depth in water. Electron beams are modeled using realistic accelerator simulations as well as beams modeled as collimated point sources from realistic electron beam spectra or monoenergetic electrons. Beam quality conversion factors are calculated with ratios of the doses to water and to the air in the ion chamber in electron beams and a cobalt-60 reference field. The overall ion chamber correction factor is studied using calculations of water-to-air stopping power ratios. Results: The use of an effective point of measurement shift of 1.55 mm from the front face of the PTW Roos chamber, which places the point of measurement inside the chamber cavity, minimizes the difference betweenR{sub 50}, the beam quality specifier, calculated from chamber simulations compared to that obtained using depth-dose calculations in water. A similar shift minimizes the variation of the overall ion chamber correction factor with depth to the practical range and reduces the root-mean-square deviation of a fit to calculated beam quality conversion factors at the reference depth as a function of R{sub 50}. Similarly, an upstream shift of 0.34 r{sub cav} allows a more accurate determination of R{sub 50} from NE2571 chamber calculations and reduces the variation of the overall ion chamber correction factor with depth. The determination of the gradient correction using a shift of 0.22 r{sub cav} optimizes the root-mean-square deviation of a fit to calculated beam quality conversion factors if all beams investigated are considered. However, if only clinical beams are considered, a good fit to results for beam quality conversion factors is obtained without explicitly correcting for gradient effects. The inadequacy of R{sub 50} to uniquely specify beam quality for the accurate selection of k{sub Q} factors is discussed. Systematic uncertainties in beam quality conversion factors are analyzed for the NE2571 chamber and amount to between 0.4% and 1.2% depending on assumptions used. Conclusions: The calculated beam quality conversion factors for the PTW Roos chamber obtained here are in good agreement with literature data. These results characterize the use of an NE2571 ion chamber for reference dosimetry of electron beams even in low-energy beams.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Predictive Modeling of Terrestrial Radiation Exposure from Geologic Materials

Aerial gamma ray surveys are important for those working in nuclear security and industry for determining locations of both anthropogenic radiological sources and natural occurrences of radionuclides. During an aerial gamma ray survey, a low flying aircraft, such as a helicopter, flies in a linear pattern across the survey area while measuring the gamma emissions with a sodium iodide (NaI) detector. Currently, if a gamma ray survey is being flown in an area, the only way to correct for geologic sources of gamma rays is to have flown the area previously. This is prohibitively expensive and would require complete national coverage. This project’s goal is to model the geologic contribution to radiological backgrounds using published geochemical data, GIS software, remote sensing, calculations, and modeling software. K, U and Th are the three major gamma emitters in geologic material. U and Th are assumed to be in secular equilibrium with their daughter isotopes. If K, U, and Th abundance values are known for a given geologic unit the expected gamma ray exposure rate can be calculated using the Grasty equation or by modeling software. Monte Carlo N-Particle Transport software (MCNP), developed by Los Alamos National Laboratory, is modeling software designed to simulate particles and their interactions with matter. Using this software, models have been created that represent various lithologies. These simulations randomly generate gamma ray photons at energy levels expected from natural radiologic sources. The photons take a random path through the simulated geologic media and deposit their energy at the end of their track. A series of nested spheres have been created and filled with simulated atmosphere to record energy deposition. Energies deposited are binned in the same manner as the NaI detectors used during an aerial survey. These models are used in place of the simplistic Grasty equation as they take into account absorption properties of the lithology which the simplistic equation ignores.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2013

Application of activity pencil beam algorithm using measured distribution data of positron emitter nuclei for therapeutic SOBP proton beam

Purpose: Recently, much research on imaging the clinical proton-irradiated volume using positron emitter nuclei based on target nuclear fragment reaction has been carried out. The purpose of this study is to develop an activity pencil beam (APB) algorithm for a simulation system for proton-activated positron-emitting imaging in clinical proton therapy using spread-out Bragg peak (SOBP) beams.Methods: The target nuclei of activity distribution calculations are {sup 12}C nuclei, {sup 16}O nuclei, and {sup 40}Ca nuclei, which are the main elements in a human body. Depth activity distributions with SOBP beam irradiations were obtained from the material information of ridge filter (RF) and depth activity distributions of compounds of the three target nuclei measured by BOLPs-RGp (beam ON-LINE PET system mounted on a rotating gantry port) with mono-energetic Bragg peak (MONO) beam irradiations. The calculated data of depth activity distributions with SOBP beam irradiations were sorted in terms of kind of nucleus, energy of proton beam, SOBP width, and thickness of fine degrader (FD), which were verified. The calculated depth activity distributions with SOBP beam irradiations were compared with the measured ones. APB kernels were made from the calculated depth activity distributions with SOBP beam irradiations to construct a simulation system using the APB algorithm for SOBP beams.Results: The depth activity distributions were prepared using the material information of RF and the measured depth activity distributions with MONO beam irradiations for clinical therapy using SOBP beams. With the SOBP width widening, the distal fall-offs of depth activity distributions and the difference from the depth dose distributions were large. The shapes of the calculated depth activity distributions nearly agreed with those of the measured ones upon comparison between the two. The APB kernels of SOBP beams were prepared by making use of the data on depth activity distributions with SOBP beam irradiations that were made from the depth activity distributions with MONO beam irradiations and sorted in terms of energy, SOBP width, and thickness of FD. The data on APB kernels of SOBP beams were determined as installment data for the simulation system using the APB algorithm for SOBP beam irradiations.Conclusions: A method of obtaining the depth activity distributions and the APB algorithm for clinical use of SOBP beams have been developed. It is suggested that the simulation system for imaging the clinical irradiated volume with the APB algorithm can be used in clinical proton therapy using SOBP beams by preparing and investigating the data on APB kernels of SOBP beams.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Calculated organ doses using Monte Carlo simulations in a reference male phantom undergoing HDR brachytherapy applied to localized prostate carcinoma

Purpose: The aim of this study was to obtain equivalent doses in radiosensitive organs (aside from the bladder and rectum) when applying high-dose-rate (HDR) brachytherapy to a localized prostate carcinoma using {sup 60}Co or {sup 192}Ir sources. These data are compared with results in a water phantom and with expected values in an infinite water medium. A comparison with reported values from proton therapy and intensity-modulated radiation therapy (IMRT) is also provided. Methods: Monte Carlo simulations in Geant4 were performed using a voxelized phantom described in International Commission on Radiological Protection (ICRP) Publication 110, which reproduces masses and shapes from an adult reference man defined in ICRP Publication 89. Point sources of {sup 60}Co or {sup 192}Ir with photon energy spectra corresponding to those exiting their capsules were placed in the center of the prostate, and equivalent doses per clinical absorbed dose in this target organ were obtained in several radiosensitive organs. Values were corrected to account for clinical circumstances with the source located at various positions with differing dwell times throughout the prostate. This was repeated for a homogeneous water phantom. Results: For the nearest organs considered (bladder, rectum, testes, small intestine, and colon), equivalent doses given by {sup 60}Co source were smaller (8%-19%) than from {sup 192}Ir. However, as the distance increases, the more penetrating gamma rays produced by {sup 60}Co deliver higher organ equivalent doses. The overall result is that effective dose per clinical absorbed dose from a {sup 60}Co source (11.1 mSv/Gy) is lower than from a {sup 192}Ir source (13.2 mSv/Gy). On the other hand, equivalent doses were the same in the tissue and the homogeneous water phantom for those soft tissues closer to the prostate than about 30 cm. As the distance increased, the differences of photoelectric effect in water and soft tissue, and appearance of other materials such as air, bone, or lungs, produced variations between both phantoms which were at most 35% in the considered organ equivalent doses. Finally, effective doses per clinical absorbed dose from IMRT and proton therapy were comparable to those from both brachytherapy sources, with brachytherapy being advantageous over external beam radiation therapy for the furthest organs. Conclusions: A database of organ equivalent doses when applying HDR brachytherapy to the prostate with either {sup 60}Co or {sup 192}Ir is provided. According to physical considerations, {sup 192}Ir is dosimetrically advantageous over {sup 60}Co sources at large distances, but not in the closest organs. Damage to distant healthy organs per clinical absorbed dose is lower with brachytherapy than with IMRT or protons, although the overall effective dose per Gy given to the prostate seems very similar. Given that there are several possible fractionation schemes, which result in different total amounts of therapeutic absorbed dose, advantage of a radiation treatment (according to equivalent dose to healthy organs) is treatment and facility dependent.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Toward Magnetic Resonance–Only Simulation: Segmentation of Bone in MR for Radiation Therapy Verification of the Head

Purpose: To develop a practical method to localize bones in magnetic resonance (MR) images, to create “computed tomography–like” MR images (ctMRI) that could be used for radiation therapy verification, and to generate MR-based digitally reconstructed radiographs (DRR). Methods and Materials: Using T1-weighted MR images, an air mask was derived from the manual contouring of all airways within the head and neck region using axial images at 6 anatomic levels. Compact bone, spongy bone, and soft tissue masks were then automatically generated using the statistical data derived from MR intensities and the air mask. ctMRI were then generated by mapping the MR intensities of the voxels within these masks into the CT number ranges of corresponding tissues. MR-based DRRs created from ctMRI were quantitatively evaluated using the co-registered MR and CT head images of 20 stereotactic radiosurgery patients. Ten anatomical points, positioned on the skull segmented using a threshold of 300 HU, in CT and ctMRI, were used to determine the differences in distance between MR-based DRRs and CT-based DRRs, and to evaluate the geometric accuracy of ctMRI and MR-based DRRs. Results: The bony structures were identified on ctMRI and were visible in the MR-based DRRs. From the 20 patient cases, the mean geometric difference and standard deviation between the 10 anatomical points on MR-based and CT-based DRRs was −0.05 ± 0.85 mm, respectively. This included uncertainty in image fusion. The maximum distance difference was 1.88 mm. Conclusions: A practical method was developed to segment bone from MR images. The ctMRI created can be used for radiation treatment verification when MR-only simulation is performed. MR-based DRRs can be used in place of CT-based DRRs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2014

Realistic simulation of reduced-dose CT with noise modeling and sinogram synthesis using DICOM CT images

Purpose: Reducing the patient dose while maintaining the diagnostic image quality during CT exams is the subject of a growing number of studies, in which simulations of reduced-dose CT with patient data have been used as an effective technique when exploring the potential of various dose reduction techniques. Difficulties in accessing raw sinogram data, however, have restricted the use of this technique to a limited number of institutions. Here, we present a novel reduced-dose CT simulation technique which provides realistic low-dose images without the requirement of raw sinogram data. Methods: Two key characteristics of CT systems, the noise equivalent quanta (NEQ) and the algorithmic modulation transfer function (MTF), were measured for various combinations of object attenuation and tube currents by analyzing the noise power spectrum (NPS) of CT images obtained with a set of phantoms. Those measurements were used to develop a comprehensive CT noise model covering the reduced x-ray photon flux, object attenuation, system noise, and bow-tie filter, which was then employed to generate a simulated noise sinogram for the reduced-dose condition with the use of a synthetic sinogram generated from a reference CT image. The simulated noise sinogram was filtered with the algorithmic MTF and back-projected to create a noise CT image, which was then added to the reference CT image, finally providing a simulated reduced-dose CT image. The simulation performance was evaluated in terms of the degree of NPS similarity, the noise magnitude, the bow-tie filter effect, and the streak noise pattern at photon starvation sites with the set of phantom images. Results: The simulation results showed good agreement with actual low-dose CT images in terms of their visual appearance and in a quantitative evaluation test. The magnitude and shape of the NPS curves of the simulated low-dose images agreed well with those of real low-dose images, showing discrepancies of less than +/−3.2% in terms of the noise power at the peak height and +/−1.2% in terms of the spatial frequency at the peak height. The magnitudes of the noise measured for 12 different combinations the phantom size, tube current, and reconstruction kernel for the simulated and real low-dose images were very similar, with differences of 0.1 to 4.7%. Thep value for a statistical testing of the difference in the noise magnitude ranged from 0.99 to 0.11, showing that there was no difference statistically between the noise magnitudes of the real and simulated low-dose images using our method. The strength and pattern of the streak noise in an anthropomorphic phantom was also consistent with expectations. Conclusions: A novel reduced-dose CT simulation technique was developed which uses only CT images while not requiring raw sinogram data. Our method can provide realistic simulation results under reduced-dose conditions both in terms of the noise magnitude and the textual appearance. This technique has the potential to promote clinical research for patient dose reductions.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

SU-E-T-664: Radiobiological Modeling of Prophylactic Cranial Irradiation in Mice

Purpose: Prophylactic cranial irradiation (PCI) is a clinical technique used to reduce the incidence of brain metastasis and improve overall survival in select patients with ALL and SCLC, and we have shown the potential of PCI in select breast cancer patients through a mouse model (manuscript in preparation). We developed a computational model using our experimental results to demonstrate the advantage of treating brain micro-metastases early. Methods: MATLAB was used to develop the computational model of brain metastasis and PCI in mice. The number of metastases per mouse and the volume of metastases from four- and eight-week endpoints were fit to normal and log-normal distributions, respectively. Model input parameters were optimized so that model output would match the experimental number of metastases per mouse. A limiting dilution assay was performed to validate the model. The effect of radiation at different time points was computationally evaluated through the endpoints of incidence, number of metastases, and tumor burden. Results: The correlation between experimental number of metastases per mouse and the Gaussian fit was 87% and 66% at the two endpoints. The experimental volumes and the log-normal fit had correlations of 99% and 97%. In the optimized model, the correlation between number of metastases per mouse and the Gaussian fit was 96% and 98%. The log-normal volume fit and the model agree 100%. The model was validated by a limiting dilution assay, where the correlation was 100%. The model demonstrates that cells are very sensitive to radiation at early time points, and delaying treatment introduces a threshold dose at which point the incidence and number of metastases decline. Conclusion: We have developed a computational model of brain metastasis and PCI in mice that is highly correlated to our experimental data. The model shows that early treatment of subclinical disease is highly advantageous.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Respiratory-Induced Haemodynamic Changes: A Contributing Factor to IVC Filter Penetration

PurposeThe purpose of the study is to evaluate the influence of respiratory-induced vena caval hemodynamic changes on filter migration/penetration.Materials and MethodsAfter placement of either a Gunther Tulip or Celect IVC filter, 101 consecutive patients scheduled for filter retrieval were prospectively enrolled in this study. Pre-retrieval CT scans were used to assess filter complications and to calculate cross-sectional area in three locations: at level of filter strut fixation, 3 cm above and 3 cm below. A 3D finite element simulation was constructed on these data and direct IVC pressure was recorded during filter retrieval. Cross-sectional areas and pressures of the vena cava were measured during neutral breathing and in Valsalva maneuver and identified filter complications were recorded. A statistical analysis of these variables was then performed.ResultsDuring Valsalva maneuvers, a 60 % decrease of the IVC cross-sectional area and a fivefold increase in the IVC pressure were identified (p < 0.001). There was a statistically significant difference in the reduction of the cross-sectional area at the filter strut level (p < 0.001) in patient with filter penetration. Difficulty in filter retrieval was higher in penetrated or tilted filters (p < 0.001; p = 0.005). 3D computational models showed significant IVC deformation around the filter during Valsalva maneuver.ConclusionCaval morphology and hemodynamics are clearly affected by Valsalva maneuvers. A physiological reduction of IVC cross-sectional area is associated with higher risk of filter penetration, despite short dwell times. Physiologic data should be used to improve future filter designs to remain safely implanted over longer dwell times.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Evaluation of Low-Level Waste Disposal Receipt Data for Los Alamos National Laboratory Technical Area 54, Area G Disposal Facility - Fiscal Year 2011

The Los Alamos National Laboratory (LANL or the Laboratory) generates radioactive waste as a result of various activities. Operational or institutional waste is generated from a wide variety of research and development activities including nuclear weapons development, energy production, and medical research. Environmental restoration (ER), and decontamination and decommissioning (D and D) waste is generated as contaminated sites and facilities at LANL undergo cleanup or remediation. The majority of this waste is low-level radioactive waste (LLW) and is disposed of at the Technical Area 54 (TA-54), Area G disposal facility. U.S. Department of Energy (DOE) Order 435.1 (DOE, 2001) requires that radioactive waste be managed in a manner that protects public health and safety, and the environment. To comply with this order, DOE field sites must prepare and maintain site-specific radiological performance assessments for LLW disposal facilities that accept waste after September 26, 1988. Furthermore, sites are required to conduct composite analyses that account for the cumulative impacts of all waste that has been (or will be) disposed of at the facilities and other sources of radioactive material that may interact with the facilities. Revision 4 of the Area G performance assessment and composite analysis was issued in 2008 (LANL, 2008). These analyses estimate rates of radionuclide release from the waste disposed of at the facility, simulate the movement of radionuclides through the environment, and project potential radiation doses to humans for several on-site and off-site exposure scenarios. The assessments are based on existing site and disposal facility data and on assumptions about future rates and methods of waste disposal. The accuracy of the performance assessment and composite analysis depends upon the validity of the data used and assumptions made in conducting the analyses. If changes in these data and assumptions are significant, they may invalidate or call into question certain aspects of the analyses. For example, if the volumes and activities of waste disposed of during the remainder of the disposal facility's lifetime differ significantly from those projected, the doses projected by the analyses may no longer apply. DOE field sites are required to implement a performance assessment and composite analysis maintenance program. The purpose of this program is to ensure the continued applicability of the analyses through incremental improvement of the level of understanding of the disposal site and facility. Site personnel are required to conduct field and experimental work to reduce the uncertainty in the data and models used in the assessments. Furthermore, they are required to conduct periodic reviews of waste receipts, comparing them to projected waste disposal rates. The radiological inventory for Area G was updated in conjunction with Revision 4 of the performance assessment and composite analysis (Shuman, 2008). That effort used disposal records and other sources of information to estimate the quantities of radioactive waste that have been disposed of at Area G from 1959, the year the facility started receiving waste on a routine basis, through 2007. It also estimated the quantities of LLW that will require disposal from 2008 through 2044, the year in which it is assumed that disposal operations at Area G will cease. This report documents the fourth review of Area G disposal receipts since the inventory was updated and examines information for waste placed in the ground during fiscal years (FY) 2008 through 2011. The primary objective of the disposal receipt review is to ensure that the future waste inventory projections developed for the performance assessment and composite analysis are consistent with the actual types and quantities of waste being disposed of at Area G. Toward this end, the disposal data that are the subject of this review are used to update the future waste inventory projections for the disposal facility. These projections are compared to the future inventory projections that were developed for Revision 4 of the performance assessment and composite analysis. The approach used to characterize the FY 2008 through 2011 waste is generally the same as that used to characterize the inventory for the Revision 4 analyses (Shuman, 2008). This methodology is described in Section 2. The results of the disposal receipt review are presented in Section 3 and discussed in terms of their significance to the Area G analyses.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗
DOE OSTI2016

Broadly Applicable Dose Model for Radiotherapy Beams from 6-25 MV

The goal of modern external beam radiotherapy is to deliver a highly targeted radiation dose to a specified treatment volume while sparing the healthy surrounding tissue as much as possible. However, some healthy tissue radiation exposure is unavoidable. Healthy tissue in the margin of the treatment field will receive absorbed doses on the order of the prescribed dose, and tissue far out of field will receive stray dose from scattered and leakage radiation. These doses can lead to late effects such as secondary cancers both near the treatment field and far out of field in tissues only receiving stray radiation dose. Many researchers have investigated algorithms to model absorbed dose from external beam photon radiation therapy; however, none of these works have fully addressed the stray dose far from the treatment field. The AAPM Task Group Report No. 36 described three main sources of stray radiation from external beam radiation therapy delivered with electron linear accelerators. Radiation scattered from the treatment head, known as head scatter, is primarily important within about 10 cm from the field edge. Patient scatter is an important source up to around 30 cm from the field edge. Finally, leakage radiation emanates from the treatment enclosure and predominates the stray radiation dose beyond about 30 cm. Monte Carlo simulations have been a useful research tool for modeling stray dose, but these methods have not found use in clinical settings due to their complexity and long computational times. The feasibility of analytical models to predict stray dose from radiation therapy has been supported by several works, but few attempts have been made at developing models accurate for both in-field and out-of-field doses. Jagetic and Newhauser reported on one such model that predicts absorbed dose from therapeutic, scatter, and leakage radiation with promising results. This model was validated at 6 MV for Conformal Radiation Therapy (CRT) beams from an Elekta linac. Intensity Modulated Radiation Therapy (IMRT) was not considered, and the model has not been tested at beam energies greater than 6 MV. Additionally, this model relies on proprietary, machine specific parameters, and so adapting the model for use on treatment units from other manufacturers is not straightforward. In this study we aim to test whether a physics-based analytical modeling approach is broadly applicable and if sufficient accuracy can be achieved without the need for proprietary, machine specific parameters. In order to accomplish this, a new analytical model was developed that does not rely on machine specific parameters, so that it can easily be trained on measurements from whatever treatment machine is available at a given clinic. This model was tested using measured data from a variety of treatment machines and techniques in the 6 MV to 25 MV energy interval. (authors)

61 RADIATION PROTECTION AND DOSIMETRY↗