Results for “DOSIMETRY” — Page 57

DOE OSTI2015

WE-F-BRB-00: New Developments in Knowledge-Based Treatment Planning and Automation

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-F-BRB-01: The Power of Ontologies and Standardized Terminologies for Capturing Clinical Knowledge

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-F-BRB-02: Setting the Stage for Incorporation of Toxicity Measures in Treatment Plan Assessments

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-F-BRB-03: Inclusion of Data-Driven Risk Predictions in Radiation Treatment Planning in the Context of a Local Level Learning Health System

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-G-213-00: History Symposium: Radiological Physics Pioneers: Roentgen and the AAPM Award Eponyms - William Coolidge, Edith Quimby, and Marvin Williams - Who Were They and What Did They Do?

Roentgen and the Birth of Modern Medical Physics – Perry Sprawls Wilhelm Roentgen is well known for his discovery of x-radiation. What is less known and appreciated is his intensive research following the discovery to determine the characteristics of the “new kind of radiation” and demonstrate its great value for medical purposes. In this presentation we will imagine ourselves in Roentgen’s mind and follow his thinking, including questions and doubts, as he designs and conducts a series of innovative experiments that provided the foundation for the rapid growth of medical physics. Learning Objectives: Become familiar with the personal characteristics and work of Prof. Roentgen that establishes him as an inspiring model for the medical physics profession. Observe the thought process and experiments that determined and demonstrated the comprehensive characteristics of x-radiation. The AAPM Award Eponyms: William D. Coolidge, Edith H. Quimby, and Marvin M.D. Williams - Who were they and what did they do? – Lawrence N. Rothenberg William David Coolidge (1873–1975) William Coolidge was born in Hudson, NY in 1873. He obtained his BS at the Massacusetts Institute of Technology in 1896. Coolidge then went to the University of Leipzig, Germany for graduate study with physicists Paul Drude and Gustave Wiedemann and received a Ph.D. in 1899. While in Germany he met Wilhelm Roentgen. Coolidge returned to the US to teach at MIT where he was associated with Arthur A. Noyes of the Chemistry Department, working on the electrical conductivity of aqueous solutions. Willis R. Whitney, under whom Coolidge had worked before going to Germany, became head of the newly formed General Electric Research Laboratory and he invited Coolidge to work with him. In 1905, Coolidge joined the staff of the GE laboratory and was associated with it for the remainder of his life. He developed ductile tungsten filaments to replace fragile carbon filaments as the material for electric light bulb filaments. Until that innovation light bulbs had a notoriously short life. He later incorporated the ductile tungsten as a filament material for a hot cathode, fully evacuated x-ray tube, first described in 1912, which allowed higher current and x-ray output, and greater reliability than had previously been possible. These “Coolidge x-ray tubes” were far superior to the cold cathode, partial pressure gas x-ray tubes that had been in use since Roentgen’s discovery of x-rays in 1895. The Coolidge tube with incremental developments is now the key component for x-ray production in all of our modern x-ray imaging devices, such as CT scanners, interventional radiology systems, and mammography units. Coolidge was also involved in the development of sectional x-ray tubes for research and treatment that were initially designed to reach 800 kV. Additional improvements led to 1 MV and 2 MV devices. In 1932 Coolidge became director of the General Electric Research Laboratory, and in 1940, was made Vice-President and Director of Research. In 1945 he retired and was named Director Emeritus of the laboratory. Coolidge held 83 patents and was recognized for these and many other achievements by election to the National Academy of Engineers, a place in the Engineering Hall of Fame and the National Inventor’s Hall of Fame. The AAPM’s highest honor, the Coolidge Award, was named after him. He accepted Honorary Membership in the AAPM and was the first recipient of the AAPM Coolidge Award, which was presented to him in a special ceremony in Schenectady, NY in 1972 when he was 100 years old. Edith Hinckley Quimby (1891–1982) Edith Quimby was born in Rockford, IL in 1891. She graduated from Whitman College in Walla Walla, WA with a B.S. in 1913, and then obtained a masters degree from the University of California at Berkeley. Later in her career, after many significant achievements, Quimby was awarded honorary doctorates by Whitman College and Rutgers University. Edith Quimby was hired by Giacchino Failla as a radiation physicist at Memorial Hospital for Cancer in New York City. Failla had studied with Madame Curie and obtained his doctoral degree in her laboratory. After many groundbreaking medical physics studies from 1919 until 1942, they both moved to Columbia University. Dr. Quimby developed a widely employed dosimetry system for single plane implants with radium and radon seeds, and a dosimetry methodology for internal radionuclides. She was author of more than 75 scientific publications, and of significant textbooks including the first comprehensive physics textbook for radiologists “Physical Foundations of Radiology”, which was co-authored with Otto Glasser, Lauriston Taylor and James Weatherwax in the first edition, with Russell Morgan added for the second edition and Paul Goodwin for the fourth edition. With Sergei Feitelberg, M.D. she published two editions of “Radioactive Isotopes in Medicine and Biology: Basic Physics and Instrumentation”. Quimby became a renowned examiner for the American Board of Radiology when the third ABR examination, given in 1936, added physics. She served as President of the American Radium Society, received the RSNA Gold Medal, and also numerous prestigious awards given to women in science. Edith Quimby was a Charter Member of AAPM. The AAPM Lifetime Achievement Award was renamed the Edith H. Quimby Lifetime Achievement Award in her honor in 2011. Marvin Martin Dixon Williams (1902–1981) Marvin Williams was born in Walla Walla, WA in 1902, and attended the same college as Edith Quimby, graduating from Whitman College in 1926. He was greatly influenced to go into medical physics by her accomplishments. During his early career, Williams worked with James Weatherwax in Philadelphia while he was working toward an M.S. from the University of Pennsylvania. In 1931 Williams was awarded a Ph.D. in Biophysics from the University of Minnesota, with the work actually performed at the Mayo Clinic Graduate School of the University. While completing his Ph.D. studies, Marvin met Dr. Paul Hodges who had returned from the Peiping Union Medical College in Peiping (now Beijing), China. Hodges suggested that a physicist be sent to Peiping to install x-ray therapy equipment and a radon plant. Williams accepted the position and, in 1931, he and his wife Orpha left for China. Before going to China, Williams had spent time with the physics group at Memorial Hospital to learn about the operation of a radon plant. In China, he constructed the radon plant, employing 0.25 g of radium, and also installed the x-ray therapy unit. Williams and his wife returned to the US in 1935, and he accepted a research position at the Mayo Clinic. In 1950, he became Professor of Biophysics at Mayo, where he taught physics and biophysics until his retirement in 1967. Williams was also very active in the American Board of Radiology where, from 1944 through 1977, he examined over 3000 radiologists and 250 physicists. Marvin Williams was a Charter member of AAPM, served as the fourth President of AAPM in 1963, and was the fourth recipient the AAPM Coolidge Award in 1975. The Marvin Williams Award was originally established as the highest award of the American College of Medical Physics. When various functions of the ACMP were absorbed into the AAPM in 2012, the Marvin M D Williams Professional Achievement Award became one of the AAPM’s highest honors. Learning Objectives: Become familiar with the persons in whose honor the three major AAPM Award are named Learn about the achievements and activities which influenced the AAPM to name these awards in their honor.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2015

WE-G-213-02: The AAPM Award Eponyms: William D. Coolidge, Edith H. Quimby, and Marvin M.D. Williams - Who Were They and What Did They Do?

Roentgen and the Birth of Modern Medical Physics – Perry Sprawls Wilhelm Roentgen is well known for his discovery of x-radiation. What is less known and appreciated is his intensive research following the discovery to determine the characteristics of the “new kind of radiation” and demonstrate its great value for medical purposes. In this presentation we will imagine ourselves in Roentgen’s mind and follow his thinking, including questions and doubts, as he designs and conducts a series of innovative experiments that provided the foundation for the rapid growth of medical physics. Learning Objectives: Become familiar with the personal characteristics and work of Prof. Roentgen that establishes him as an inspiring model for the medical physics profession. Observe the thought process and experiments that determined and demonstrated the comprehensive characteristics of x-radiation. The AAPM Award Eponyms: William D. Coolidge, Edith H. Quimby, and Marvin M.D. Williams - Who were they and what did they do? – Lawrence N. Rothenberg William David Coolidge (1873–1975) William Coolidge was born in Hudson, NY in 1873. He obtained his BS at the Massacusetts Institute of Technology in 1896. Coolidge then went to the University of Leipzig, Germany for graduate study with physicists Paul Drude and Gustave Wiedemann and received a Ph.D. in 1899. While in Germany he met Wilhelm Roentgen. Coolidge returned to the US to teach at MIT where he was associated with Arthur A. Noyes of the Chemistry Department, working on the electrical conductivity of aqueous solutions. Willis R. Whitney, under whom Coolidge had worked before going to Germany, became head of the newly formed General Electric Research Laboratory and he invited Coolidge to work with him. In 1905, Coolidge joined the staff of the GE laboratory and was associated with it for the remainder of his life. He developed ductile tungsten filaments to replace fragile carbon filaments as the material for electric light bulb filaments. Until that innovation light bulbs had a notoriously short life. He later incorporated the ductile tungsten as a filament material for a hot cathode, fully evacuated x-ray tube, first described in 1912, which allowed higher current and x-ray output, and greater reliability than had previously been possible. These “Coolidge x-ray tubes” were far superior to the cold cathode, partial pressure gas x-ray tubes that had been in use since Roentgen’s discovery of x-rays in 1895. The Coolidge tube with incremental developments is now the key component for x-ray production in all of our modern x-ray imaging devices, such as CT scanners, interventional radiology systems, and mammography units. Coolidge was also involved in the development of sectional x-ray tubes for research and treatment that were initially designed to reach 800 kV. Additional improvements led to 1 MV and 2 MV devices. In 1932 Coolidge became director of the General Electric Research Laboratory, and in 1940, was made Vice-President and Director of Research. In 1945 he retired and was named Director Emeritus of the laboratory. Coolidge held 83 patents and was recognized for these and many other achievements by election to the National Academy of Engineers, a place in the Engineering Hall of Fame and the National Inventor’s Hall of Fame. The AAPM’s highest honor, the Coolidge Award, was named after him. He accepted Honorary Membership in the AAPM and was the first recipient of the AAPM Coolidge Award, which was presented to him in a special ceremony in Schenectady, NY in 1972 when he was 100 years old. Edith Hinckley Quimby (1891–1982) Edith Quimby was born in Rockford, IL in 1891. She graduated from Whitman College in Walla Walla, WA with a B.S. in 1913, and then obtained a masters degree from the University of California at Berkeley. Later in her career, after many significant achievements, Quimby was awarded honorary doctorates by Whitman College and Rutgers University. Edith Quimby was hired by Giacchino Failla as a radiation physicist at Memorial Hospital for Cancer in New York City. Failla had studied with Madame Curie and obtained his doctoral degree in her laboratory. After many groundbreaking medical physics studies from 1919 until 1942, they both moved to Columbia University. Dr. Quimby developed a widely employed dosimetry system for single plane implants with radium and radon seeds, and a dosimetry methodology for internal radionuclides. She was author of more than 75 scientific publications, and of significant textbooks including the first comprehensive physics textbook for radiologists “Physical Foundations of Radiology”, which was co-authored with Otto Glasser, Lauriston Taylor and James Weatherwax in the first edition, with Russell Morgan added for the second edition and Paul Goodwin for the fourth edition. With Sergei Feitelberg, M.D. she published two editions of “Radioactive Isotopes in Medicine and Biology: Basic Physics and Instrumentation”. Quimby became a renowned examiner for the American Board of Radiology when the third ABR examination, given in 1936, added physics. She served as President of the American Radium Society, received the RSNA Gold Medal, and also numerous prestigious awards given to women in science. Edith Quimby was a Charter Member of AAPM. The AAPM Lifetime Achievement Award was renamed the Edith H. Quimby Lifetime Achievement Award in her honor in 2011. Marvin Martin Dixon Williams (1902–1981) Marvin Williams was born in Walla Walla, WA in 1902, and attended the same college as Edith Quimby, graduating from Whitman College in 1926. He was greatly influenced to go into medical physics by her accomplishments. During his early career, Williams worked with James Weatherwax in Philadelphia while he was working toward an M.S. from the University of Pennsylvania. In 1931 Williams was awarded a Ph.D. in Biophysics from the University of Minnesota, with the work actually performed at the Mayo Clinic Graduate School of the University. While completing his Ph.D. studies, Marvin met Dr. Paul Hodges who had returned from the Peiping Union Medical College in Peiping (now Beijing), China. Hodges suggested that a physicist be sent to Peiping to install x-ray therapy equipment and a radon plant. Williams accepted the position and, in 1931, he and his wife Orpha left for China. Before going to China, Williams had spent time with the physics group at Memorial Hospital to learn about the operation of a radon plant. In China, he constructed the radon plant, employing 0.25 g of radium, and also installed the x-ray therapy unit. Williams and his wife returned to the US in 1935, and he accepted a research position at the Mayo Clinic. In 1950, he became Professor of Biophysics at Mayo, where he taught physics and biophysics until his retirement in 1967. Williams was also very active in the American Board of Radiology where, from 1944 through 1977, he examined over 3000 radiologists and 250 physicists. Marvin Williams was a Charter member of AAPM, served as the fourth President of AAPM in 1963, and was the fourth recipient the AAPM Coolidge Award in 1975. The Marvin Williams Award was originally established as the highest award of the American College of Medical Physics. When various functions of the ACMP were absorbed into the AAPM in 2012, the Marvin M D Williams Professional Achievement Award became one of the AAPM’s highest honors. Learning Objectives: Become familiar with the persons in whose honor the three major AAPM Award are named Learn about the achievements and activities which influenced the AAPM to name these awards in their honor.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

Development of computational small animal models and their applications in preclinical imaging and therapy research

The development of multimodality preclinical imaging techniques and the rapid growth of realistic computer simulation tools have promoted the construction and application of computational laboratory animal models in preclinical research. Since the early 1990s, over 120 realistic computational animal models have been reported in the literature and used as surrogates to characterize the anatomy of actual animals for the simulation of preclinical studies involving the use of bioluminescence tomography, fluorescence molecular tomography, positron emission tomography, single-photon emission computed tomography, microcomputed tomography, magnetic resonance imaging, and optical imaging. Other applications include electromagnetic field simulation, ionizing and nonionizing radiation dosimetry, and the development and evaluation of new methodologies for multimodality image coregistration, segmentation, and reconstruction of small animal images. This paper provides a comprehensive review of the history and fundamental technologies used for the development of computational small animal models with a particular focus on their application in preclinical imaging as well as nonionizing and ionizing radiation dosimetry calculations. An overview of the overall process involved in the design of these models, including the fundamental elements used for the construction of different types of computational models, the identification of original anatomical data, the simulation tools used for solving various computational problems, and the applications of computational animal models in preclinical research. The authors also analyze the characteristics of categories of computational models (stylized, voxel-based, and boundary representation) and discuss the technical challenges faced at the present time as well as research needs in the future.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2016

Technical Note: Radiation properties of tissue- and water-equivalent materials formulated using the stoichiometric analysis method in charged particle therapy

Purpose: Five tissue- and water-equivalent materials (TEMs) mimicking ICRU real tissues have been formulated using a previously established stoichiometric analysis method (SAM) to be applied in charged particle therapy. The purpose of this study was an experimental verification of the TEMs-SAM against charged particle beam measurements and for different computed tomography (CT) scanners. The potential of the TEMs-SAM to be employed in the dosimetry was also investigated. Methods: Experimental verification with three CT scanners was carried out to validate the calculated Hounsfield units (HUs) of the TEMs. Water-equivalent path lengths (WEPLs) of the TEMs for proton (106.8 MeV/u), helium (107.93 MeV/u), and carbon (200.3 MeV/u) ions were measured to be compared with the computed relative stopping powers. HU calibration curves were also generated. Results: Differences between the measured HUs of the TEMs and the calculated HUs of the ICRU real tissues for all CT scanners were smaller than 4 HU except for the skeletal tissues which deviated up to 21 HU. The measured WEPLs verified the calculated WEPLs of the TEMs (maximum deviation was 0.17 mm) and were in good agreement with the calculated WEPLs of the ICRU real tissues (maximum deviation was 0.23 mm). Moreover, the relative stopping powers converted from the measured WEPLs differed less than 0.8% and 1.3% from the calculated values of the SAM and the ICRU, respectively. Regarding the relative nonelastic cross section per unit of volume for 200 MeV protons, the ICRU real tissues were generally well represented by the TEMs except for adipose which differed 3.8%. Further, the HU calibration curves yielded the mean and the standard deviation of the errors not larger than 0.5% and 1.9%, respectively. Conclusions: The results of this investigation implied the potential of the TEMs formulated using the SAM to be employed for both, beam dosimetry and HU calibration in charged particle therapy.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2016

Helium ions for radiotherapy? Physical and biological verifications of a novel treatment modality

Purpose: Modern facilities for actively scanned ion beam radiotherapy allow in principle the use of helium beams, which could present specific advantages, especially for pediatric tumors. In order to assess the potential use of these beams for radiotherapy, i.e., to create realistic treatment plans, the authors set up a dedicated {sup 4}He beam model, providing base data for their treatment planning system TRiP98, and they have reported that in this work together with its physical and biological validations. Methods: A semiempirical beam model for the physical depth dose deposition and the production of nuclear fragments was developed and introduced in TRiP98. For the biological effect calculations the last version of the local effect model was used. The model predictions were experimentally verified at the HIT facility. The primary beam attenuation and the characteristics of secondary charged particles at various depth in water were investigated using {sup 4}He ion beams of 200 MeV/u. The nuclear charge of secondary fragments was identified using a ΔE/E telescope. 3D absorbed dose distributions were measured with pin point ionization chambers and the biological dosimetry experiments were realized irradiating a Chinese hamster ovary cells stack arranged in an extended target. Results: The few experimental data available on basic physical processes are reproduced by their beam model. The experimental verification of absorbed dose distributions in extended target volumes yields an overall agreement, with a slight underestimation of the lateral spread. Cell survival along a 4 cm extended target is reproduced with remarkable accuracy. Conclusions: The authors presented a simple simulation model for therapeutical {sup 4}He beams which they introduced in TRiP98, and which is validated experimentally by means of physical and biological dosimetries. Thus, it is now possible to perform detailed treatment planning studies with {sup 4}He beams, either exclusively or in combination with other ion modalities.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

Technical Note: Partial body irradiation of mice using a customized PMMA apparatus and a clinical 3D planning/LINAC radiotherapy system

Purpose: In vivo radiobiology experiments involving partial body irradiation (PBI) of mice are of major importance because they allow for the evaluation of individual organ tolerance; overcoming current limitations of experiments using lower dose, whole body irradiation. In the current study, the authors characterize and validate an effective and efficient apparatus for multiple animal PBI, directed to the head, thorax, or abdomen of mice. Methods: The apparatus is made of polymethylmethacrylate and consists of a rectangular parallelepiped prism (40 cm × 16 cm × 8 cm), in which five holes were drilled to accomodate standard 60 ml syringes, each housing an unanesthetized, fully immobilized mouse. Following CT-scanning and radiotherapy treatment planning, radiation fields were designed to irradiate the head, thorax, or abdomen of the animal. Thermoluminescent dosimeters (TLDs) were used to confirm the treatment planning dosimetry for primary beam and scattered radiation. Results: Mice are efficiently placed into 60 ml syringes and immobilized, without the use of anesthetics. Although partial rotational movement around the longitudinal axis and a minor 2 mm forward/backward movement are permitted, this does not compromise the irradiation of the chosen body area. TLDs confirmed the dose values predicted by the treatment planning dosimetry, both for primary beam and scattered radiation. Conclusions: The customized PMMA apparatus described and validated is cost-effective, convenient to use, and efficient in performing PBI without the use of anesthesia. The developed apparatus permits the isolated irradiation of the mouse head, thorax, and abdomen. Importantly, the apparatus allows the delivery of PBI to five mice, simultaneously, representing an efficient way to effectively expose a large number of animals to PBI through multiple daily fractions, simulating clinical radiotherapy treatment schedules.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-C-BRC-01: A Monte Carlo Study of Out-Of-Field Doses From Cobalt-60 Teletherapy Units Intended for Historical Correlations of Dose to Normal Tissue

Purpose: Innovations in radiotherapy treatments, such as dynamic IMRT, VMAT, and SBRT/SRS, result in larger proportions of low-dose regions where normal tissues are exposed to low doses levels. Low doses of radiation have been linked to secondary cancers and cardiac toxicities. The AAPM TG Committee No.158 entitled, ‘Measurements and Calculations of Doses outside the Treatment Volume from External-Beam Radiation Therapy’, has been formed to review the dosimetry of non-target and out-of-field exposures using experimental and computational approaches. Studies on historical patients can provide comprehensive information about secondary effects from out-of-field doses when combined with long-term patient follow-up, thus providing significant insight into projecting future outcomes of patients undergoing modern-day treatments. Methods: We present a Monte Carlo model of a Theratron-1000 cobalt-60 teletherapy unit, which historically treated patients at the University of Florida, as a means of determining doses located outside the primary beam. Experimental data for a similar Theratron-1000 was obtained at the University of Wisconsin’s ADCL to benchmark the model for out-of-field dosimetry. An Exradin A12 ion chamber and TLD100 chips were used to measure doses in an extended water phantom to 60 cm outside the primary field at 5 and 10 cm depths. Results: Comparison between simulated and experimental measurements of PDDs and lateral profiles show good agreement for in-field and out-of-field doses. At 10 cm away from the edge of a 6×6, 10×10, and 20×20 cm2 field, relative out-of-field doses were measured in the range of 0.5% to 3% of the dose measured at 5 cm depth along the CAX. Conclusion: Out-of-field doses can be as high as 90 to 180 cGy assuming historical prescription doses of 30 to 60 Gy and should be considered when correlating late effects with normal tissue dose.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-J-121: Dosimetric Evaluation of Active Breathing Coordinator-Response Gating System Linked to Linear Accelerator in Volumetric Modulated Arc Therapy

Purpose: To reduce internal target volume (ITV), respiratory management is a must in imaging and treatment for lung, liver, and breast cancers. We investigated the dosimetric accuracy of VMAT treatment delivery with a Response™ gating system linked to linear accelerator. Methods: The Response™ gating module designed to directly control radiation beam by breath-holding with a ABC system (Elekta AB, Stockholm, Sweden) was tested for VMAT treatments. Seven VMAT plans including three conventional and four stereotactic body radiotherapy (SBRT) cases were evaluated. Each plan was composed of two or four arcs of 6MV radiation beam with prescribed dose ranged from 1.8 to 9 Gy per fraction. Each plan was delivered continuously without gating and delivered with multiple interruptions by the ResponseTM gating module with a 20 or 30 second breath-holding period. MapCheck2 and Gafchromic EBT3 films sandwiched in MapPHAN were used to measure the delivered dose with and without gating. Films were scanned on a flatbed color scanner, and red channel was extracted for film dosimetry. Gamma analysis was performed to analyze the dosimetrical accuracy of the radiation delivery with gating. Results: The measured doses with gating remarkably agree with the planned dose distributions in the results of gamma index passing rate (within 20% isodose; >98% for 3%/3mm and >92% for 2%/2mm in MapCheck2, and >91% for 3%/3mm criteria in EBT3 film except one case which was for large target and highly modulated). No significant difference (student t-test: p-value < 0.0005) was shown between the doses delivered with and without gating. There was no indication of radiation gap or overlapping during deliver interruption in film dosimetry. Conclusion: The Response™ gating system can be safely used during VMAT treatment. The accurate performance of the gating system linked to ABC can contribute to ITV reduction for SBRT using VMAT.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-259: GPR Tables for the Estimation of Mid-Plane Dose Using EPID

Purpose: To develop a simple method for estimating the mid-plane dose (MPD) of a patient using Electronic Portal imaging Device (EPID). Methods: A Varian TrueBeam with aSi100 EPID was used in this study. The EPID images were acquired for a 30 cm × 30 cm homogeneous slab phantom and a 30 cm diameter 20 cm thick cylindrical phantom in the continuous dosimetry mode. The acquired EPID images in XIM format were imported into in-house MATLAB program for the data analysis. First, the dosimetric characteristics of EPID were studied for dose-response linearity, dose-rate dependence, and field size dependence. Next, the average pixels values of the EPID images were correlated with the MPD measured by an ionisation chamber for various thicknesses of the slab phantom (8 cm – 30 cm) and for various square field sizes (3×3 cm{sup 2} – 25×25 cm{sup 2} at the isocenter). Look-up tables called as GPR tables were then generated for both SSD and SAD setup by taking the ratio of MPD measured by the ionisation chamber and the corresponding EPID pixel values. The accuracy of the GPR tables was evaluated by varying the field size, phantom thickness, and wedge angles with the slab and cylindrical phantoms. Results: The dose response of EPID was linear from 20 MU to 300 MU. The EPID response for different dose rates from 40 MU/min to 600 MU/min was within ±1%. The difference in the doses from the GPR tables and the doses measured by the ionization chambers were within 2% for slab phantoms, and 3% for the cylindrical phantom for various field sizes, phantom thickness, and wedge angles. Conclusion: GPR tables are a ready reckoner for in-vivo dosimetry and it can be used to quickly estimate the MPD value from the EPID images with an accuracy of ±3% for common clinical treatment. project work funded by Union for International cancer control(UICC) under ICRETT fellowship.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-320: Assessing Placement Error of Optically Stimulated Luminescent in Vivo Dosimeters Using Cone-Beam Computed Tomography

Purpose: Optically-stimulated luminescent dosimeters (OSLDs) are increasingly utilized for in vivo dosimetry of complex radiation delivery techniques such as intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT). Evaluation of clinical uncertainties such as placement error has not been performed. This work retrospectively investigates the magnitude of placement error using conebeam computed tomography (CBCT) and its effect on measured/planned dose agreement. Methods: Each OSLD was placed at a physicist-designated location on the patient surface on a weekly basis. The location was given in terms of a gantry angle and two-dimensional offset from central axis. The OSLDs were placed before daily image guidance. We identified 77 CBCTs from 25 head-and-neck patients who received IMRT or VMAT, where OSLDs were visible on the CT image. Grossly misplaced OSLDs were excluded (e.g. wrong laterality). CBCTs were registered with the treatment plan and the distance between the planned and actual OSLD location was calculated in two dimensions in the beam’s eye view. Distances were correlated with measured/planned dose percent differences. Results: OSLDs were grossly misplaced for 5 CBCTs (6.4%). For the remaining 72 CBCTs, average placement error was 7.0±6.0 mm. These errors were not correlated with measured/planned dose percent differences (R{sup 2}=0.0153). Generalizing the dosimetric effect of placement errors may be unreliable. Conclusion: Correct placement of OSLDs for IMRT and VMAT treatments is critical to accurate and precise in vivo dosimetry. Small placement errors could produce large disagreement between measured and planned dose. Further work includes expansion to other treatment sites, examination of planned dose at the actual point of OSLD placement, and the influence of imageguided shifts on measured/planned dose agreement.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-476: Performance of the AS1200 EPID for Periodic Photon Quality Assurance

Purpose: To assess the dosimetric performance of a new amorphous silicon flat-panel electronic portal imaging device (EPID) suitable for high-intensity, flattening-filter-free delivery mode. Methods: An EPID-based QA suite was created with automation to periodically monitor photon central-axis output and two-dimensional beam profile constancy as a function of gantry angle and dose-rate. A Varian TrueBeamTM linear accelerator installed with Developer Mode was used to customize and deliver XML script routines for the QA suite using the dosimetry mode image acquisition for an aS1200 EPID. Automatic post-processing software was developed to analyze the resulting DICOM images. Results: The EPID was used to monitor photon beam output constancy (central-axis), flatness, and symmetry over a period of 10 months for four photon beam energies (6x, 15x, 6xFFF, and 10xFFF). EPID results were consistent to those measured with a standard daily QA check device. At the four cardinal gantry angles, the standard deviation of the EPID central-axis output was <0.5%. Likewise, EPID measurements were independent for the wide range of dose rates (including up to 2400 mu/min for 10xFFF) studied with a standard deviation of <0.8% relative to the nominal dose rate for each energy. Also, profile constancy and field size measurements showed good agreement with the reference acquisition of 0° gantry angle and nominal dose rate. XML script files were also tested for MU linearity and picket-fence delivery. Using Developer Mode, the test suite was delivered in <60 minutes for all 4 photon energies with 4 dose rates per energy and 5 picket-fence acquisitions. Conclusion: Dosimetry image acquisition using a new EPID was found to be accurate for standard and high-intensity photon beams over a broad range of dose rates over 10 months. Developer Mode provided an efficient platform to customize the EPID acquisitions by using custom script files which significantly reduced the time. This work was funded in part by Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-495: Method for Simultaneous Commissioning of Multiple Truebeam (TB) Linacs: Small Field Data and the Choice of Dosimetric Lead Gap (DLG)

Purpose: Many times a set of multiple Varian-Truebeam (TB) linacs are acquired by an institution. Since “beam matching” is an important requirement for many facilities, we developed a strategy to perform a “simultaneous” commissioning between multiple linacs.Methods and Materials: We first commissioned the required photon beam data for eclipse on the 1st TB for all the energy modalities with a beam scanning system, while integrated measurements for output factors, of all field sizes (from 1×1 to 40×40cm{sup 2}) were conducted on the 2nd TB. Care was exercised during small field dosimetry so the appropriate detectors were used with data taken between two detectors be “linked” to a larger field size (4×4cm{sup 2}) with the “daisy-chaining” technique via: OF=[M-PTW(fs)×(M-PTW(4×4))-1]×[MA12s(4×4)×(M-A12S(10×10))−1]. For all energy modalities, data that span the entire range of field size, was repeated on the next TB linac, for verification. The primarily energy-dependent dosimetric leaf gap (DLG) which was measured separately on each TB. The modeled data was validated with special measurements conducted on both linacs during commissioning. Results: Our data agreed with the “TB representative beam data” to within 0.5% for all energy modalities and field sizes ≥3×3cm2. Sample depth-doses and cross-profiles of a 3×3cm2 between the linacs agreeing to within 1% between linacs. The measured DLGs were quite different with a uniform difference of 1.3% between the two linacs. The measured DLG values are independent of the average dose rate and medium used for the measurements. Conclusion: A comprehensive method of commissioning identical Varian-TB linacs, outlining the critical issues, especially small field dosimetry and DLG. The dosimetric effect of different DLG values, when it comes to, dynamic delivery and data comparisons will be presented. The dependence of DLG value on the measurement medium (in-air vs. water) or dose rate used will also be discussed. This work was supported by CAMC Cancer Center and Alliance Oncology.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2016

SU-F-T-508: A Collimator-Based 3-Dimensional Grid Therapy Technique in a Small Animal Radiation Research Platform

Purpose: Three dimensional (3D) Grid Therapy using MLC-based inverse-planning has been proposed to achieve the features of both conformal radiotherapy and spatially fractionated radiotherapy, which may deliver very high dose in a single fraction to portions of a large tumor with relatively low normal tissue dose. However, the technique requires relatively long delivery time. This study aims to develop a collimator-based 3D grid therapy technique. Here we report the development of the technique in a small animal radiation research platform. Methods: Similar as in the MLC-based technique, 9 non-coplanar beams in special channeling directions were used for the 3D grid therapy technique. Two specially designed grid collimators were fabricated, and one of them was selectively used to match the corresponding gantry/couch angles so that the grid opening of all 9 beams are met in the 3D space in the target. A stack of EBT3 films were used as 3D dosimetry to demonstrate the 3D grid-like dose distribution in the target. Three 1-mm beams were delivered to the stack of films in the area outside the target for alignment when all the films were scanned to reconstruct the 3D dosimtric image. Results: 3D film dosimetry showed a lattice-like dose distribution in the 3D target as well as in the axial, sagittal and coronal planes. The dose outside the target also showed a grid like dose distribution, and the average dose gradually decreased with the distance to the target. The peak to valley ratio was approximately 5:1. The delivery time was 7 minutes for 18 Gy peak dose, comparing to 6 minutes to deliver a 18-Gy 3D conformal plan. Conclusion: We have demonstrated the feasibility of the collimator-based 3D grid therapy technique which can significantly reduce delivery time comparing to MLC-based inverse planning technique.

60 APPLIED LIFE SCIENCES↗

DOE OSTI2016

SU-F-T-585: A Novel Phantom for Dosimetric Validation of SBRT for Spinal Lesions

Purpose: SBRT is proving to be a very efficacious treatment modality for an increasing number of indications, including spine lesions. We have developed a novel phantom to serve as an end-to-end QA tool for either patient specific QA or commissioning QA of SBRT for spine lesions. Methods: In this feasibility study, we have selected a patient with a single metastatic lesion in the L5 vertebral body. The patient’s CT simulation scan was used to develop a VMAT treatment plan delivering 18Gy to at least 90% of the target volume, following the guidelines of RTOG 0631. The treatment plan was developed with the Pinnacle planning system using the adaptive convolution superposition calculation mode. The approved plan was re-calculated using the Monaco planning system. We performed a pseudo-in-vivo study whereby we manufactured two copies of a phantom to the exact shape and anatomy of the patient. The phantom was made from the CT images of the patient using a 3D printer with sub-millimeter accuracy. One phantom was filled with a gel dosimeter and the other was made with two ion chamber inserts to allow us to obtain point dose measurements in the target’s center and the spinal cord. Results: The prescribed dose of 18Gy was planned for the target while keeping the maximum spinal cord dose to less than 14Gy in 0.03cc of the cord. The VMAT plan was delivered to both the gel dosimeter filed phantom and the phantom with the ion chambers. The 3D gel dosimetry revealed a very good agreement between the monte carlo and measured point and volumetric dose. Conclusion: A patient like phantom was developed and validated for use as an end-to-end tool of dose verification for SBRT of spine lesions. We found that gel dosimetry is ideally suited to assess positional and dosimetric accuracy in 3D. RTsafe provided the phantoms and the gel dosimeter used for this study.

60 APPLIED LIFE SCIENCES↗