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At least 1,207 records · Page 67
All sourcesNASA NTRSDOE OSTI
DOE OSTI2018

Cumulative dose of radiation therapy of hepatocellular carcinoma patients and its deterministic relation to radiation-induced liver disease

This study aimed to investigate the relationship between dose and radiation-induced liver disease (RILD) in patients with hepatocellular carcinoma (HCC) receiving 3-dimensional conformal radiotherapy (3DCRT). Twenty-three patients with HCC who received conventional fractionated 3DCRT, including 7 who were diagnosed with classic RILD, were enrolled in this retrospective investigation. Cone-beam computed tomography (CBCT) scans were acquired at the time of treatment for each patient. The beams from each patient's treatment plan were applied to each pretreatment CBCT (the modified CBCT or mCBCT) to construct the delivered dose distribution of the day considering inter-treatment anatomy changes. The daily doses were summed together with the help of deformable image registration (DIR) to obtain the adjusted cumulative dose (D{sub adjusted}). The dose changes to the normal liver between the original planned dose (D{sub plan}) and D{sub adjusted} were evaluated by V20, V30, V40, and the mean dose to normal liver (MDTNL). Univariate analysis was performed to identify the significant dose changes. Among the 23 patients, the liver V20, V30, V40, and MDTNL showed significant differences between D{sub plan} and D{sub adjusted}, with average values of these parameters increased by 4.1%, 4.7%, 4.5%, and 3.9 Gy, respectively (p adjusted . Determination of a reconstructed D{sub adjusted} using the mCBCT scans are more accurate in predicting RILD and has the potential to reduce the risk of RILD.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

The environmental chemical tributyltin chloride (TBT) shows both estrogenic and adipogenic activities in mice which might depend on the exposure dose

Exposure during early development to chemicals with hormonal action may be associated with weight gain during adulthood because of altered body homeostasis. It is known that organotins affect adipose mass when exposure occurs during fetal development, although no knowledge of effects are available for exposures after birth. Here we show that the environmental organotin tributyltin chloride (TBT) exerts adipogenic action when peripubertal and sexually mature mice are exposed to the chemical. The duration and extent of these effects depend on the sex and on the dose of the compound, and the effects are relevant at doses close to the estimated human intake (0.5 {mu}g/kg). At higher doses (50-500 {mu}g/kg), TBT also activated estrogen receptors (ERs) in adipose cells in vitro and in vivo, based on results from acute and longitudinal studies in ERE/luciferase reporter mice. In 3T3-L1 cells (which have no ERs), transiently transfected with the ERE-dependent reporter plus or minus ER{alpha} or ER{beta}, TBT (in a dose range of 1-100 nM) directly targets each ER subtype in a receptor-specific manner through a direct mechanism mediated by ER{alpha} in undifferentiated preadipocytic cells and by ER{beta} in differentiating adipocytes. The ER antagonist ICI-182,780 inhibits this effect. In summary, the results of this work suggest that TBT is adipogenic at all ages and in both sexes and that it might be an ER activator in fat cells. These findings might help to resolve the apparent paradox of an adipogenic chemical being also an estrogen receptor activator by showing that the two apparently opposite actions are separated by the different doses to which the organism is exposed. - Research Highlights: > The environmental organotin tributyltin chloride shows dose-dependent estrogenic and adipogenic activities in mice. > The duration and extent of these effects depend on the sex and the dose of the compound. > The estrogenic and adipogenic effects of TBT occur at doses closed to the estimated human intake. > TBT activates the estrogen receptors (ER{alpha} and ER{beta}) in 3T3-L1 cells at nM concentrations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2026

Effects of temperature and dose rate on ion-irradiated γ-LiAlO 2 pellets

Defect accumulation and microstructural evolution during ion irradiation at elevated temperatures are governed by competing processes of defect production, driven by the dose rate, and defect recovery, controlled by diffusion, interaction, and annihilation. Here, this study investigates the effects of irradiation temperature and the dose rate on microstructural evolution, deuterium retention, and lithium volatilization in γ-LiAlO 2 pellets subjected to sequential He + and D + ion irradiation. Experiments were performed to a total fluence of 3 × 10 17 (He + + D + )/cm 2 at 623, 673, 723, and 773 K with an average He + dose rate of 7.7 × 10 −4 dpa/s, and to 2 × 10 17 (He + + D + )/cm 2 at 773 K with dose rates of 6.8 × 10 −5 , 2.9 × 10 −4 , and 7.3 × 10 −4 dpa/s. At 623 K, the microstructure was dominated by cavities and fractures with no observable precipitate formation, while small precipitates emerged at 673 K. Increasing the irradiation temperature to 723–773 K promoted the formation of larger, faceted LiAl 5 O 8 precipitates, and surface amorphization, accompanied by pronounced lithium depletion and H–D isotopic exchange. At 773 K, medium and high dose rates produced an amorphized surface layer over a crystalline subsurface containing LiAl 5 O 8 precipitates and blisters at the crystalline–amorphous interface, whereas low-dose-rate irradiation preserved surface crystallinity with cavities distributed in the matrix, around precipitates, and along grain boundaries. Precipitate morphology was anisotropic with limited size dependence on the dose rate. These results elucidate the coupled effects of temperature and the dose rate and demonstrate that sequential He + and D 2 + irradiation at 773 K reproduces key microstructural features and H isotope behavior observed in neutron-irradiated γ-LiAlO 2 at 573 K.

dose rate effects↗
DOE OSTI2014

Low-dose radiation from 18 F-FDG PET does not increase cancer frequency or shorten latency but reduces kidney disease in cancer-prone Trp53+/- mice

There is considerable interest in the health effects associated with low-level radiation exposure from medical imaging procedures. Concerns in the medical community that increased radiation exposure from imaging procedures may increase cancer risk among patients are confounded by research showing that low-dose radiation exposure can extend lifespan by increasing the latency period of some types of cancer. The most commonly used radiopharmaceutical for positron emission tomography (PET) scans is 2-[ 18 F] fluoro-2-deoxy-d-glucose ( 18 F-FDG), which exposes tissue to a low-dose, mixed radiation quality: 634 keV β+ and 511 keV γ-rays. The goal of this research was to investigate how modification of cancer risk associated with exposure to low-dose ionising radiation in cancer-prone Trp53 +/- mice is influenced by radiation quality from PET. At 7-8 weeks of age, Trp53 +/- female mice were exposed to one of five treatments: 0 Gy, 10 mGy γ-rays, 10 mGy 18 F-FDG, 4 Gy γ-rays, 10 mGy 18 F-FDG + 4 Gy γ-rays (n > 185 per group). The large 4-Gy radiation dose significantly reduced the lifespan by shortening the latency period of cancer and significantly increasing the number of mice with malignancies, compared with unirradiated controls. The 10 mGy γ-rays and 10 mGy PET doses did not significantly modify the frequency or latency period of cancer relative to unirradiated mice. Similarly, the PET scan administered prior to a large 4-Gy dose did not significantly modify the latency or frequency of cancer relative to mice receiving a dose of only 4 Gy. The relative biological effectiveness of radiation quality from 18 F-FDG, with respect to malignancy, is approximately 1. Furthermore, when non-cancer endpoints were studied, it was found that the 10-mGy PET group had a significant reduction in kidney lesions (P < 0.021), indicating that a higher absorbed dose (20 ± 0.13 mGy), relative to the whole-body average, which occurs in specific tissues, may not be detrimental.

18F-FDG RBE 1.0↗
DOE OSTI2012

Effects of B{sub 18}H{sub x}{sup +} and B{sub 18}H{sub x} dimer ion implantations on crystallinity and retained B dose in silicon

The effects of B{sub 18}H{sub x}{sup +} and B{sub 18}H{sub x} dimer ion (B{sub 36}H{sub y}{sup +}) implantations on Si crystallinity and the retained B dose in Si were investigated using B{sub 18}H{sub x} bombardment and compared with the effects of B{sup +} implantation. Crystallinity was estimated for the implantation dose using molecular dynamic simulations (MDSs) and was quantified using the optical thickness obtained from spectroscopic ellipsometry. The authors focused on the crystallinity at a low B dose and compared the amorphized zones predicted by MDS for B{sub 18}H{sub x}{sup +} implantation with those measured using transmission electron microscopy; the predicted and measured results were in reasonable agreement. The authors then used their understanding of B{sub 18}H{sub x} bombardment to discuss the process for the generation of larger amorphized zones and thicker amorphized layers, as observed in B{sub 36}H{sub y}{sup +} implantation. The retained B dose and the sputtering were examined with secondary ion mass spectroscopy, focusing on a comparison of the retained B and the sputtering of Si and SiO{sub 2} surfaces. The retained B dose was lower for B{sub 18}H{sub x}{sup +} and B{sub 36}H{sub y}{sup +} implantations, with and without surface SiO{sub 2}, than for B{sup +} implantation, although no sputtering was observed. The reduction of the retained B dose was more severe in the samples with SiO{sub 2}. The origin of the differences between Si and SiO{sub 2} surfaces was considered to be Si melting; this was predicted by the MDSs, and observed indirectly as flat B profiles in the Si region. To examine the effects of both crystallinity and retained B dose on the electrical characteristics, the sheet resistance (R{sub S}) was measured. The R{sub S} for B{sub 18}H{sub x}{sup +} implantation was lower than that for B{sup +} implantation at both B doses studied. Additionally, the B{sub 36}H{sub y}{sup +} implantation under conditions that produced a thicker amorphized layer led to lower R{sub S} than B{sub 18}H{sub x}{sup +} implantation. These results indicate that both the amorphized layer and the amorphized zone contribute to the activation of more B atoms.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2012

Dose homogeneity specification for reference dosimetry of nonstandard fields

Purpose: To investigate the sensitivity of the plan-class specific correction factor to dose distributions in composite nonstandard field dosimetry. Methods: A cylindrical water-filled PMMA phantom was constructed at the center of which reference absorbed dose could be measured. Ten different TomoTherapy-based IMRT fields were created on the CT images of the phantom. The dose distribution for each IMRT field was estimated at the position of a radiation detector or ionization chamber. The dose in each IMRT field normalized to that in a reference 10 x 10 cm{sup 2} field was measured using a PTW micro liquid ion chamber. Based on the new dosimetry formalism, a plan-class specific correction factor k{sub Q{sub p{sub c{sub s{sub r,Q}{sup f{sub p}{sub c}{sub s}{sub r},f{sub r}{sub e}{sub f}}}}}} for each field was measured for two Farmer-type chambers, Exradin A12 and NE2571, as well as for a smaller Exradin A1SL chamber. The dependence of the measured correction factor on parameters characterizing dose distribution was analyzed. Results: Uncertainty on the plan-class specific correction factor measurement was in the range of 0.3%-0.5% and 0.3%-0.8% for the Farmer-type chambers and the Exradin A1SL, respectively. When the heterogeneity of the central region of the target volume was less than 5%, the correction factor did not differ from unity by more than 0.7% for the three air-filled ionization chambers. For more heterogeneous dose deliveries, the correction factor differed from unity by up to 2.4% for the Farmer-type chambers. For the Exradin A1SL, the correction factor was closer to unity due to the reduced effect of dose gradients, while it was highly variable in different IMRT fields because of a more significant impact of positioning uncertainties on the response of this chamber. Conclusions: The authors have shown that a plan-class specific correction factor can be specified as a function of plan evaluation parameters especially for Farmer-type chambers. This work provides a recipe based on quantifying dose distribution to accurately select air-filled ionization chamber correction factors for nonstandard fields.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

A method to estimate the effect of deformable image registration uncertainties on daily dose mapping

Purpose: To develop a statistical sampling procedure for spatially-correlated uncertainties in deformable image registration and then use it to demonstrate their effect on daily dose mapping. Methods: Sequential daily CT studies are acquired to map anatomical variations prior to fractionated external beam radiotherapy. The CTs are deformably registered to the planning CT to obtain displacement vector fields (DVFs). The DVFs are used to accumulate the dose delivered each day onto the planning CT. Each DVF has spatially-correlated uncertainties associated with it. Principal components analysis (PCA) is applied to measured DVF error maps to produce decorrelated principal component modes of the errors. The modes are sampled independently and reconstructed to produce synthetic registration error maps. The synthetic error maps are convolved with dose mapped via deformable registration to model the resulting uncertainty in the dose mapping. The results are compared to the dose mapping uncertainty that would result from uncorrelated DVF errors that vary randomly from voxel to voxel. Results: The error sampling method is shown to produce synthetic DVF error maps that are statistically indistinguishable from the observed error maps. Spatially-correlated DVF uncertainties modeled by our procedure produce patterns of dose mapping error that are different from that due to randomly distributed uncertainties. Conclusions: Deformable image registration uncertainties have complex spatial distributions. The authors have developed and tested a method to decorrelate the spatial uncertainties and make statistical samples of highly correlated error maps. The sample error maps can be used to investigate the effect of DVF uncertainties on daily dose mapping via deformable image registration. An initial demonstration of this methodology shows that dose mapping uncertainties can be sensitive to spatial patterns in the DVF uncertainties.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2012

Dedicated breast CT: radiation dose for circle-plus-line trajectory

Purpose: Dedicated breast CT prototypes used in clinical investigations utilize single circular source trajectory and cone-beam geometry with flat-panel detectors that do not satisfy data-sufficiency conditions and could lead to cone beam artifacts. Hence, this work investigated the glandular dose characteristics of a circle-plus-line trajectory that fulfills data-sufficiency conditions for image reconstruction in dedicated breast CT. Methods: Monte Carlo-based computer simulations were performed using the GEANT4 toolkit and was validated with previously reported normalized glandular dose coefficients for one prototype breast CT system. Upon validation, Monte Carlo simulations were performed to determine the normalized glandular dose coefficients as a function of x-ray source position along the line scan. The source-to-axis of rotation distance and the source-to-detector distance were maintained constant at 65 and 100 cm, respectively, in all simulations. The ratio of the normalized glandular dose coefficient at each source position along the line scan to that for the circular scan, defined as relative normalized glandular dose coefficient (RD{sub g}N), was studied by varying the diameter of the breast at the chest wall, chest-wall to nipple distance, skin thickness, x-ray beam energy, and glandular fraction of the breast. Results: The RD{sub g}N metric when stated as a function of source position along the line scan, relative to the maximum length of line scan needed for data sufficiency, was found to be minimally dependent on breast diameter, chest-wall to nipple distance, skin thickness, glandular fraction, and x-ray photon energy. This observation facilitates easy estimation of the average glandular dose of the line scan. Polynomial fit equations for computing the RD{sub g}N and hence the average glandular dose are provided. Conclusions: For a breast CT system that acquires 300-500 projections over 2{pi} for the circular scan, the addition of a line trajectory with equal source spacing and constant x-ray beam quality (kVp and HVL) and mAs matched to the circular scan, will result in less than 0.18% increase in average glandular dose to the breast per projection along the line scan.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Evaluation of clinical IMRT treatment planning using the GATE Monte Carlo simulation platform for absolute and relative dose calculations

Purpose: The objective of this study was to evaluate and validate the use of the Geant4 application for emission tomography (GATE) Monte Carlo simulation platform for clinical intensity modulated radiotherapy (IMRT) dosimetry studies. Methods: The first step consisted of modeling a 6 MV photon beam linear accelerator (LINAC), with its corresponding validation carried out using percent depth dose evaluation, transverse profiles, tissue phantom ratio, and output factor on water phantom. The IMRT evaluation was performed by comparing simulation and measurements in terms of absolute and relative doses using IMRT dedicated quality assurance phantoms considering seven different patient datasets. Results: Concerning the LINAC simulated model validation tissue phantom ratios at 20 and 10 cm in water TPR{sub 10}{sup 20} obtained from GATE and measurements were 0.672 {+-} 0.063 and 0.675, respectively. In terms of percent depth dose and transverse profiles, error ranges were, respectively: 1.472%{+-} 0.285% and 4.827%{+-} 1.323% for field size of 4 Multiplication-Sign 4, 5 Multiplication-Sign 5, 10 Multiplication-Sign 10, 15 Multiplication-Sign 15, 20 Multiplication-Sign 20, 25 Multiplication-Sign 25, 30 Multiplication-Sign 30, and 40 Multiplication-Sign 40 cm{sup 2}. Most errors were observed at the edge of radiation fields because of higher dose gradient in these areas. Output factors showed good agreement between simulation and measurements with a maximum error of 1.22%. Finally, for IMRT simulations considering seven patient datasets, GATE provided good results with a relative error of 0.43%{+-} 0.25% on absolute dose between simulated and measured beams (measurements at the isocenter, volume 0.125 cm{sup 3}). Planar dose comparisons were also performed using gamma-index analysis. For the whole set of beams considered the mean gamma-index value was 0.497 {+-} 0.152 and 90.8%{+-} 3.6% of the evaluated dose points satisfied the 5%/ 4 mm criterion. Conclusions: These results show that GATE allows reliable simulation of complex beams in radiotherapy after an accurate LINAC modeling is validated. A simple cross-calibration procedure proposed in this work allows obtaining absolute dose values even in complex fields.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2013

Progressive cone beam CT dose control in image-guided radiation therapy

Purpose: Cone beam CT (CBCT) in image-guided radiotherapy (IGRT) offers a tremendous advantage for treatment guidance. The associated imaging dose is a clinical concern. One unique feature of CBCT-based IGRT is that the same patient is repeatedly scanned during a treatment course, and the contents of CBCT images at different fractions are similar. The authors propose a progressive dose control (PDC) scheme to utilize this temporal correlation for imaging dose reduction. Methods: A dynamic CBCT scan protocol, as opposed to the static one in the current clinical practice, is proposed to gradually reduce the imaging dose in each treatment fraction. The CBCT image from each fraction is processed by a prior-image based nonlocal means (PINLM) module to enhance its quality. The increasing amount of prior information from previous CBCT images prevents degradation of image quality due to the reduced imaging dose. Two proof-of-principle experiments have been conducted using measured phantom data and Monte Carlo simulated patient data with deformation. Results: In the measured phantom case, utilizing a prior image acquired at 0.4 mAs, PINLM is able to improve the image quality of a CBCT acquired at 0.2 mAs by reducing the noise level from 34.95 to 12.45 HU. In the synthetic patient case, acceptable image quality is maintained at four consecutive fractions with gradually decreasing exposure levels of 0.4, 0.1, 0.07, and 0.05 mAs. When compared with the standard low-dose protocol of 0.4 mAs for each fraction, an overall imaging dose reduction of more than 60% is achieved. Conclusions: PINLM-PDC is able to reduce CBCT imaging dose in IGRT utilizing the temporal correlations among the sequence of CBCT images while maintaining the quality.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

An algorithm to calculate a collapsed arc dose matrix in volumetric modulated arc therapy

Purpose: The delivery of volumetric modulated arc therapy (VMAT) is more complex than other conformal radiotherapy techniques. In this work, the authors present the feasibility of performing routine verification of VMAT delivery using a dose matrix measured by a gantry mounted 2D ion chamber array and corresponding dose matrix calculated by an inhouse developed algorithm.Methods: Pinnacle, v9.0, treatment planning system (TPS) was used in this study to generate VMAT plans for a 6 MV photon beam from an Elekta-Synergy linear accelerator. An algorithm was developed and implemented with inhouse computer code to calculate the dose matrix resulting from a VMAT arc in a plane perpendicular to the beam at isocenter. The algorithm was validated using measurement of standard patterns and clinical VMAT plans with a 2D ion chamber array. The clinical VMAT plans were also validated using ArcCHECK measurements. The measured and calculated dose matrices were compared using gamma ({gamma}) analysis with 3%/3 mm criteria and {gamma} tolerance of 1.Results: The dose matrix comparison of standard patterns has shown excellent agreement with the mean {gamma} pass rate 97.7 ({sigma}= 0.4)%. The validation of clinical VMAT plans using the dose matrix predicted by the algorithm and the corresponding measured dose matrices also showed good agreement with the mean {gamma} pass rate of 97.6 ({sigma}= 1.6)%. The validation of clinical VMAT plans using ArcCHECK measurements showed a mean pass rate of 95.6 ({sigma}= 1.8)%.Conclusions: The developed algorithm was shown to accurately predict the dose matrix, in a plane perpendicular to the beam, by considering all possible leaf trajectories in a VMAT delivery. This enables the verification of VMAT delivery using a 2D array detector mounted on a treatment head.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2013

Dosimetric characterization of the GammaClip™{sup 169}Yb low dose rate permanent implant brachytherapy source for the treatment of nonsmall cell lung cancer postwedge resection

Purpose: A novel {sup 169}Yb low dose rate permanent implant brachytherapy source, the GammaClip™, was developed by Source Production and Equipment Co. (New Orleans, LA) which is designed similar to a surgical staple while delivering therapeutic radiation. In this report, the brachytherapy source was characterized in terms of “Dose calculation for photon-emitting brachytherapy sources with average energy higher than 50 keV: Report of the AAPM and ESTRO” by Perez-Calatayud et al. [Med. Phys. 39, 2904–2929 (2012)] using the updated AAPM Task Group Report No. 43 formalism.Methods: Monte Carlo calculations were performed using Monte Carlo N-Particle 5, version 1.6 in water and air, the in-air photon spectrum filtered to remove photon energies below 10 keV in accordance with TG-43U1 recommendations and previously reviewed {sup 169}Yb energy cutoff levels [D. C. Medich, M. A. Tries, and J. M. Munro, “Monte Carlo characterization of an Ytterbium-169 high dose rate brachytherapy source with analysis of statistical uncertainty,” Med. Phys. 33, 163–172 (2006)]. TG-43U1 dosimetric data, including S{sub K}, D-dot (r,θ), Λ, g{sub L}(r), F(r, θ), φ{sub an}(r), and φ{sub an} were calculated along with their statistical uncertainties. Since the source is not axially symmetric, an additional set of calculations were performed to assess the resulting axial anisotropy.Results: The brachytherapy source's dose rate constant was calculated to be (1.22 ± 0.03) cGy h{sup −1} U{sup −1}. The uncertainty in the dose to water calculations, D-dot (r,θ), was determined to be 2.5%, dominated by the uncertainties in the cross sections. The anisotropy constant, φ{sub an}, was calculated to be 0.960 ± 0.011 and was obtained by integrating the anisotropy factor between 1 and 10 cm using a weighting factor proportional to r{sup −2}. The radial dose function was calculated at distances between 0.5 and 12 cm, with a maximum value of 1.20 at 5.15 ± 0.03 cm. Radial dose values were fit to a fifth order polynomial and dual exponential regression. Since the source is not axially symmetric, angular Monte Carlo calculations were performed at 1 cm which determined that the maximum azimuthal anisotropy was less than 8%.Conclusions: With a higher photon energy, shorter half-life and higher initial dose rate {sup 169}Yb is an interesting alternative to {sup 125}I for the treatment of nonsmall cell lung cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Evaluating IMRT and VMAT dose accuracy: Practical examples of failure to detect systematic errors when applying a commonly used metric and action levels

Purpose: This study (1) examines a variety of real-world cases where systematic errors were not detected by widely accepted methods for IMRT/VMAT dosimetric accuracy evaluation, and (2) drills-down to identify failure modes and their corresponding means for detection, diagnosis, and mitigation. The primary goal of detailing these case studies is to explore different, more sensitive methods and metrics that could be used more effectively for evaluating accuracy of dose algorithms, delivery systems, and QA devices.Methods: The authors present seven real-world case studies representing a variety of combinations of the treatment planning system (TPS), linac, delivery modality, and systematic error type. These case studies are typical to what might be used as part of an IMRT or VMAT commissioning test suite, varying in complexity. Each case study is analyzed according to TG-119 instructions for gamma passing rates and action levels for per-beam and/or composite plan dosimetric QA. Then, each case study is analyzed in-depth with advanced diagnostic methods (dose profile examination, EPID-based measurements, dose difference pattern analysis, 3D measurement-guided dose reconstruction, and dose grid inspection) and more sensitive metrics (2% local normalization/2 mm DTA and estimated DVH comparisons).Results: For these case studies, the conventional 3%/3 mm gamma passing rates exceeded 99% for IMRT per-beam analyses and ranged from 93.9% to 100% for composite plan dose analysis, well above the TG-119 action levels of 90% and 88%, respectively. However, all cases had systematic errors that were detected only by using advanced diagnostic techniques and more sensitive metrics. The systematic errors caused variable but noteworthy impact, including estimated target dose coverage loss of up to 5.5% and local dose deviations up to 31.5%. Types of errors included TPS model settings, algorithm limitations, and modeling and alignment of QA phantoms in the TPS. Most of the errors were correctable after detection and diagnosis, and the uncorrectable errors provided useful information about system limitations, which is another key element of system commissioning.Conclusions: Many forms of relevant systematic errors can go undetected when the currently prevalent metrics for IMRT/VMAT commissioning are used. If alternative methods and metrics are used instead of (or in addition to) the conventional metrics, these errors are more likely to be detected, and only once they are detected can they be properly diagnosed and rooted out of the system. Removing systematic errors should be a goal not only of commissioning by the end users but also product validation by the manufacturers. For any systematic errors that cannot be removed, detecting and quantifying them is important as it will help the physicist understand the limits of the system and work with the manufacturer on improvements. In summary, IMRT and VMAT commissioning, along with product validation, would benefit from the retirement of the 3%/3 mm passing rates as a primary metric of performance, and the adoption instead of tighter tolerances, more diligent diagnostics, and more thorough analysis.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Out-of-field organ doses and associated radiogenic risks from para-aortic radiotherapy for testicular seminoma

Purpose: The aims of this study were to (a) calculate the radiation dose to out-of-field organs from radiotherapy for stage I testicular seminoma and (b) estimate the associated radiogenic risks. Methods: Monte Carlo methodology was employed to model radiation therapy with typical anteroposterior and posteroanterior para-aortic fields on an anthropomorphic phantom simulating an average adult. The radiation dose received by all main and remaining organs that defined by the ICRP publication 103 and excluded from the treatment volume was calculated. The effect of field dimensions on each organ dose was determined. Additional therapy simulations were generated by introducing shielding blocks to protect the kidneys from primary radiation. The gonadal dose was employed to assess the risk of heritable effects for irradiated male patients of reproductive potential. The lifetime attributable risks (LAR) of radiotherapy-induced cancer were estimated using gender- and organ-specific risk coefficients for patient ages of 20, 30, 40, and 50 years old. The risk values were compared with the respective nominal risks. Results: Para-aortic irradiation to 20 Gy resulted in out-of-field organ doses of 5.0–538.6 mGy. Blocked field treatment led to a dose change up to 28%. The mean organ dose variation by increasing or decreasing the applied field dimensions was 18.7% ± 3.9% and 20.8% ± 4.5%, respectively. The out-of-field photon doses increased the lifetime intrinsic risk of developing thyroid, lung, bladder, prostate, and esophageal cancer by (0.1–1.4)%, (0.4–1.1)%, (2.5–5.4)%, (0.2–0.4)%, and (6.4–9.2)%, respectively, depending upon the patient age at exposure and the field size employed. A low risk for heritable effects of less than 0.029% was found compared with the natural incidence of these defects. Conclusions: Testicular cancer survivors are subjected to an increased risk for the induction of bladder and esophageal cancer following para-aortic radiotherapy. The probability for the appearance of any other malignant disease to out-of-field organs was slightly elevated in respect to the nominal cancer incidence rates.

61 RADIATION PROTECTION AND DOSIMETRY↗
DOE OSTI2014

Assessing image quality and dose reduction of a new x-ray computed tomography iterative reconstruction algorithm using model observers

Purpose: A number of different techniques have been developed to reduce radiation dose in x-ray computed tomography (CT) imaging. In this paper, the authors will compare task-based measures of image quality of CT images reconstructed by two algorithms: conventional filtered back projection (FBP), and a new iterative reconstruction algorithm (IR). Methods: To assess image quality, the authors used the performance of a channelized Hotelling observer acting on reconstructed image slices. The selected channels are dense difference Gaussian channels (DDOG).A body phantom and a head phantom were imaged 50 times at different dose levels to obtain the data needed to assess image quality. The phantoms consisted of uniform backgrounds with low contrast signals embedded at various locations. The tasks the observer model performed included (1) detection of a signal of known location and shape, and (2) detection and localization of a signal of known shape. The employed DDOG channels are based on the response of the human visual system. Performance was assessed using the areas under ROC curves and areas under localization ROC curves. Results: For signal known exactly (SKE) and location unknown/signal shape known tasks with circular signals of different sizes and contrasts, the authors’ task-based measures showed that a FBP equivalent image quality can be achieved at lower dose levels using the IR algorithm. For the SKE case, the range of dose reduction is 50%–67% (head phantom) and 68%–82% (body phantom). For the study of location unknown/signal shape known, the dose reduction range can be reached at 67%–75% for head phantom and 67%–77% for body phantom case. These results suggest that the IR images at lower dose settings can reach the same image quality when compared to full dose conventional FBP images. Conclusions: The work presented provides an objective way to quantitatively assess the image quality of a newly introduced CT IR algorithm. The performance of the model observers using the IR images was always higher than that seen using the FBP images in the authors’ SKE and SKE location unknown detection tasks. To achieve a FBP-equivalent image quality in CT systems, the authors can lower the radiation dose by using this IR image reconstruction algorithm. Further studies are warranted using clinical data and human observer to validate these results for more complicated and realistic tasks.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-D-9A-07: Imaging Dose and Cancer Risk in Image-Guided Radiotherapy of Cancers

Purpose: To systematically evaluate the imaging doses and cancer risks associated with various imaging procedures involving ionizing radiation during image-guided radiotherapy of an increasingly large number of cancer patients. Methods: 141 patients (52 brain cases, 47 thoracic cases, 42 abdominal cases, aged 3 to 91 years old) treated between October 2009 and March 2010 were included in this IRB-approved retrospective study. During the whole radiotherapy course, each patient underwent at least one type of imaging procedures, i.e., kV portal, MV portal and kVCBCT, besides CT simulations. Based on Monte Carlo modeling and particle transport in human anatomy of various dimensions, the correlations between the radiation doses to the various organs-at-risk (OARs) at the head, the thoracic and the abdominal regions and one's weight, circumference, scan mAs and kVp have been obtained and used to estimate the radiation dose from a specific imaging procedure. The radiation-induced excess relative risk (ERR) was then estimated with BEIR VII formulism based on one's gender, age and radiation dose. 1+ ERR was reported in this study as relative cancer risk. Results: For the whole cohort of 141 patients, the mean imaging doses from various imaging procedures were 8.3 cGy to the brain, 10.5 cGy to the lungs and 19.2 cGy to the red bone marrow, respectively. Accordingly, the cancer risks were 1.140, 1.369 and 2.671, respectively. In comparison, MV portal deposited largest doses to the lungs while kVCBCT delivered the highest doses to the red bone marrow. Conclusion: The compiled imaging doses to a patient during his/her treatment course were patient-specific and site-dependent, varying from 1.2 to 263.5 cGy on average, which were clinically significant and should be included in the treatment planning and overall decision-making. Our results indicated the necessity of personalized imaging to maximize its clinical benefits while reducing the associated cancer risks. Sichuan University Scholarship.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

SU-E-J-38: Comparison of 6MV Photon Dose in a Perpendicular and Parallel Magnetic Field

Purpose: Integrating a linac with an MRI system would allow for real time tumour tracking however the patient will be irradiated in the presence of a magnetic field. The present study experimentally investigates the magnetic field effects on entrance, exit, and interface dose for both transverse and parallel magnetic fields. Methods: Polystyrene was used to construct a set of phantoms for Gafchromic film measurements. One phantom had an adjustable air gap and four other phantoms had one surface at various angles. The linac-MR prototype consisting of a biplanar permanent magnet coupled to a linac was used for the transverse magnetic field measurements. A couple of solenoid electromagnets, stacked on top of each other and irradiated along their bore, were used for the parallel field measurements. Results: All doses are relative to no magnetic field. The transverse magnetic field reduced the entrance dose for all surface angles by strongly deflecting the contaminant electrons. The exit dose in a transverse magnetic field was found to be significantly higher. The entrance dose with a parallel magnetic field present is higher due to the contaminant electrons being concentrated within the beam area. The air gap phantom measurements, done in a transverse magnetic field, show a significant increase of the dose at the proximal side of the air gap and a decrease at the distal side. The measurements, done in the parallel magnetic field, show the concentration of secondary electrons in the air gap. Conclusion: The radiation dose measurements of a 6MV beam in a parallel and transverse magnetic field presented here are currently being replicated using Monte Carlo simulations. This verified Monte Carlo system could provide the dose calculation basis for future linac-MR systems.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

SU-E-J-101: Retroactive Calculation of TLD and Film Dose in Anthropomorphic Phantom as Assessment of Updated TPS Performance

Purpose: To demonstrate a quick and comprehensive method verifying the accuracy of the updated dose model by recalculating dose distribution in an anthropomorphic phantom with a new version of the TPS and comparing the results to measured values. Methods: CT images and IMRT plan of an RPC anthropomorphic head phantom, previously calculated by Pinnacle 9.0, was re-computed using Pinnacle 9.2 and 9.6. The dosimeters within the phantom include four TLD capsules representing a primary PTV, two TLD capsules representing a secondary PTV, and two TLD capsules representing an organ at risk. Also included were three sheets of Gafchromic film. Performance of the updated TPS version was assessed by recalculating point doses and dose profiles corresponding to TLD and film position respectively and then comparing the results to reported values by the RPC. Results: Comparing calculated doses to reported measured doses from the RPC yielded an average disagreement of 1.48%, 2.04% and 2.10% for versions 9.0, 9.2, 9.6 respectively. Computed doses points all meet the RPC's passing criteria with the exception of the point representing the superior organ at risk in version 9.6. However, qualitative analysis of the recalculated dose profiles showed improved agreement with those of the RPC, especially in the penumbra region. Conclusion: This work has demonstrated the calculation results of Pinnacle 9.2 and 9.6 vs 9.0 version. Additionally, this study illustrates a method for the user to gain confidence upgrade to a newer version of the treatment planning system.

60 APPLIED LIFE SCIENCES↗