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At least 1,315 records · Page 73
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DOE OSTI2014

MO-H-19A-02: Investigation of Modulated Electron Arc (MeArc) Therapy for the Treatment of Scalp Tumors

Purpose: Electron arc therapy has long been proposed as the most suitable technique for the treatment of superficial tumors that follow circularly curved surfaces. However it was challenged by unsuitability of the conventional applicators and the lack of adequate 3-D dose calculation tools for arc electron beams in the treatment planning systems (TPS). Now with the availability of an electron specific multi-leaf collimator (eMLC) and an in-house Monte Carlo (MC) based TPS, we were motivated to investigate more advanced modulated electron arc (MeARC) therapy and its beneficial outcome. Methods: We initiated the study by a film measurement conducted in a head and neck phantom, where we delivered electron arcs in a step and shoot manner using the light field as a guide to avoid fields abutments. This step was done to insure enough clearance for the arcs with eMLC. MCBEAM and MCPLAN MC codes were used for the treatment head simulation and phantom dose calculation, respectively. Treatment plans were generated for targets drawn in real patient CTs and head and neck phantom. We utilized beams eye view available from a commercial planning system to create beamlets having same isocenter and adjoined at the scalp surface. Then dose-deposition coefficients from those beamlets were calculated for all electron energies using MCPLAN. An in-house optimization code was then used to find the optimum weights needed from individual beamlets. Results: MeARC showed a nicely tailored dose distribution around the circular curved target on the scalp. Some hot spots were noticed and could be attributed to fields abutment problem owing to the bulging nature of electron profiles. Brain dose was shown to be at lower levels compared to photon treatment. Conclusion: MeARC was shown to be a promising modality for treating scalp cases and could be beneficial to all superficial tumors with a circular curvature.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TU-A-9A-05: First Experimental Demonstration of the Anisotropic Detection Principle in X-Ray Fluorescence Computed Tomography

Purpose: To improve the sensitivity of X-ray fluorescence computed tomography (XFCT) for in vivo molecular imaging. Is the maximum sensitivity achieved with an isotropic (4π) detector configuration? We prove that this is not necessarily true, and that a greater sensitivity is possible with anisotropic detector configuration. Methods: An XFCT imaging system was constructed consisting of 1) a collimated pencil beam x-ray source using a fluoroscopy grade x-ray tube; 2) a CdTe x-ray photon counting detector to detect fluorescent x-rays; and 3) a rotation/translation stage for tomographic imaging. We created a 6.5-cm diameter water phantom with 2-cm inserts of low gold concentration (0.25%–1%) to simulate tumors targeted by gold nano-particles. The placement of x-ray fluorescence detector were chosen to minimize scatter x-rays. XFCT imaging was performed at three different detector positions (60°, 90°, 145°) to determine the impact of forward-scatter, side-scatter, and back-scatter on imaging performance. The three data sets were also combined to estimate the imaging performance with an isotropic detector. Results: The highest imaging performance was achieved when the XF detector was in the backscatter 145° configuration. The signal-to-noise ratio (SNR) was 5.5 for the 0.25% gold concentration compared to SNRs of 1.4, 0, and 2.4 for 60°, 90°, and combined (60°+90°+145°) datasets. Only the 145° detector arrangement alone could detect the 0.25% concentration. The imaging dose was 14 mGy for each detector arrangement experiment. Conclusion: This study experimentally proves, for the fist time, the Anisotropic Detection Principle in XF imaging, which holds that optimized anisotropic x-ray fluorescence detection provides greater sensitivity than isotropic detection. The optimized detection arrangement was used to improve the sensitivity of the XFCT experiment. The achieved XFCT sensitivity is the highest ever for a phantom at least this large using a benchtop x-ray source, which is an important step toward clinical XFCT molecular imaging. This work was supported by the NCI fellowship grant R25T-CA118681 and by the NIH (1R01-EB016777) and NIBIB (1K99-EB016059)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TU-F-BRE-04: Development of a High-Resolution EPID Based Dosimetry Strategy for Radiosurgery QA

Purpose: To systematically investigate a high spatial-resolution (0.2mm) electronic portal imaging device (EPID) for CyberKnife (CK) based radiosurgery system quality assurance (QA). Methods: An EPID-based dosimetric measurement technique is applied to CK output measurement and field size verification. A Monte Carlo (MC) simulated pixel-to-pixel EPID response specific to CK is used to convert a raw EPID-measured image of a radiosurgery field into water-based dose distribution. The output factors are measured using EPID for radiosurgery fields formed by fixed and variable aperture (Iris) cones. Circular fields of 5, 7.5, 10, 15, 30 and 60mm diameters are measured and compared with diode measurements. The equivalent diameters are determined by analyzing the area received dose greater than half maximum. Results: For both fixed and Iris cones, the EPID measured output factors of circular fields of 5mm to 60mm diameters are in good agreement with the radiosurgery diode measurements. The mean output differences are 1.0% and 1.5% for fixed and Iris cone respectively. The max differences are 2.2% for the 15mm fixed cone, and 1.8% for the 10mm Iris field. The equivalent diameters derived from the EPID measurements are in good agreement comparing to the water scan result with mean differences of 0.21±0.09mm and 0.02±0.22mm for fixed and Iris cone, respectively. The high detector density EPID is able to measure the whole radiation field and identify the field edge and center. Therefore, there is no need to align the detector center perfectly at field center and the setup time is greatly reduced for QA. Conclusion: The high spatial-resolution EPID is proved to be an accurate and efficient dosimetric tool for radiosurgery QA and especially useful in Cyberknife QA for variable aperture collimators.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

TU-F-18A-09: CT Number Stability Across Patient Sizes Using Virtual-Monoenergetic Dual-Energy CT

Purpose: Virtual-monoenergetic imaging uses dual-energy CT data to synthesize images corresponding to a single photon energy, thereby reducing beam-hardening artifacts. This work evaluated the ability of a commercial virtual-monoenergetic algorithm to achieve stable CT numbers across patient sizes. Methods: Test objects containing a range of iodine and calcium hydroxyapatite concentrations were placed inside 8 torso-shaped water phantoms, ranging in lateral width from 15 to 50 cm, and scanned on a dual-source CT system (Siemens Somatom Force). Single-energy scans were acquired from 70-150 kV in 10 kV increments; dual-energy scans were acquired using 4 energy pairs (low energy: 70, 80, 90, and 100 kV; high energy: 150 kV + 0.6 mm Sn). CTDIvol was matched for all single- and dual-energy scans for a given phantom size. All scans used 128×0.6 mm collimation and were reconstructed with 1-mm thickness at 0.8-mm increment and a medium smooth body kernel. Monoenergetic images were generated using commercial software (syngo Via Dual Energy, VA30). Iodine contrast was calculated as the difference in mean iodine and water CT numbers from respective regions-of-interest in 10 consecutive images. Results: CT numbers remained stable as phantom width varied from 15 to 50 cm for all dual-energy data sets (except for at 50 cm using 70/150Sn due to photon starvation effects). Relative to the 15 cm phantom, iodine contrast was within 5.2% of the 70 keV value for phantom sizes up to 45 cm. At 90/150Sn, photon starvation did not occur at 50 cm, and iodine contrast in the 50-cm phantom was within 1.4% of the 15-cm phantom. Conclusion: Monoenergetic imaging, as implemented in the evaluated commercial system, eliminated the variation in CT numbers due to patient size, and may provide more accurate data for quantitative tasks, including radiation therapy treatment planning. Siemens Healthcare.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

TU-F-12A-04: Differential Radiation Avoidance of Functional Liver Regions Defined by 99mTc-Sulfur Colloid SPECT/CT with Proton Therapy

Purpose: Radiotherapy for hepatocellular carcinoma patients is conventionally planned without consideration of spatial heterogeneity in hepatic function, which may increase risk of radiation-induced liver disease. Pencil beam scanning (PBS) proton radiotherapy (pRT) plans were generated to differentially decrease dose to functional liver volumes (FLV) defined on [{sup 99m}Tc]sulfur colloid (SC) SPECT/CT images (functional avoidance plans) and compared against conventional pRT plans. Methods: Three HCC patients underwent SC SPECT/CT scans for pRT planning acquired 15 min post injection over 24 min. Images were reconstructed with OSEM following scatter, collimator, and exhale CT attenuation correction. Functional liver volumes (FLV) were defined by liver:spleen uptake ratio thresholds (43% to 90% maximum). Planning objectives to FLV were based on mean SC SPECT uptake ratio relative to GTV-subtracted liver and inversely scaled to mean liver dose of 20 Gy. PTV target coverage (V{sub 95}) was matched between conventional and functional avoidance plans. PBS pRT plans were optimized in RayStation for single field uniform dose (SFUD) and systematically perturbed to verify robustness to uncertainty in range, setup, and motion. Relative differences in FLV DVH and target dose heterogeneity (D{sub 2}-D{sub 98})/D50 were assessed. Results: For similar liver dose between functional avoidance and conventional PBS pRT plans (D{sub mean}≤5% difference, V{sub 18Gy}≤1% difference), dose to functional liver volumes were lower in avoidance plans but varied in magnitude across patients (FLV{sub 70%max} D{sub mean}≤26% difference, V{sub 18Gy}≤8% difference). Higher PTV dose heterogeneity in avoidance plans was associated with lower functional liver dose, particularly for the largest lesion [(D{sub 2}-D{sub 98})/D{sub 50}=13%, FLV{sub 90%max}=50% difference]. Conclusion: Differential avoidance of functional liver regions defined on sulfur colloid SPECT/CT is feasible with proton therapy. The magnitude of benefit appears to be patient specific and dependent on tumor location, size, and proximity to functional volumes. Further investigation in a larger cohort of patients may validate the clinical utility of functional avoidance planning of HCC radiotherapy.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-D-17A-04: Magnetically Focused Proton Irradiation of Small Volume Targets

Purpose: To explore the advantages of magnetic focusing for small volume proton irradiations and the potential clinical benefits for radiosurgery targets. The primary goal is to create narrow elongated proton beams of elliptical cross section with superior dose delivery characteristics compared to current delivery modalities (eg, collimated beams). In addition, more general beam shapes are also under investigation. Methods: Two prototype magnets consisting of 24 segments of samarium-cobalt (Sm2Co17) permanent magnetic material adhered into hollow cylinders were manufactured for testing. A single focusing magnet was placed on a positioning track on our Gantry 1 treatment table and 15 mm diameter proton beams with energies and modulation relevant to clinical radiosurgery applications (127 to 186 MeV, and 0 to 30 mm modulation) were delivered to a terminal water tank. Beam dose distributions were measured using a PTW diode detector and Gafchromic EBT2 film. Longitudinal and transverse dose profiles were analyzed and compared to data from Monte Carlo simulations analogous to the experimental setup. Results: The narrow elongated focused beam spots showed high elliptical symmetry indicating high magnet quality. In addition, when compared to unfocused beams, peak-to-entrance depth dose ratios were 11 to 14% larger (depending on presence or extent of modulation), and minor axis penumbras were 11 to 20% smaller (again depending on modulation) for focused beams. These results suggest that the use of rare earth magnet assemblies is practical and could improve dose-sparing of normal tissue and organs at risk while delivering enhanced dose to small proton radiosurgery targets. Conclusion: Quadrapole rare earth magnetic assemblies are a promising and inexpensive method to counteract particle out scatter that tends to degrade the peak to entrance performance of small field proton beams. Knowledge gained from current experiments will inform the design of a prototype treatment nozzle that incorporates similar focusing magnets. This project was sponsored in part by funding from the Department of Defense (DOD# W81XWH-BAA-10-1)

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-G-BRD-08: End-To-End Targeting Accuracy of the Gamma Knife for Trigeminal Neuralgia

Purpose: Current QA procedures verify accuracy of individual equipment parameters, but may not include CT and MRI localizers. This study uses an end-to-end approach to measure the overall targeting errors in individual patients previously treated for trigeminal neuralgia. Methods: The trigeminal nerve is simulated by a 3 mm long, 3.175 mm (1/8 inch) diameter MRI contrast-filled cavity embedded within a PMMA plastic capsule. The capsule is positioned within the head frame such that the cavity position matches the Gamma Knife coordinates of 10 previously treated patients. Gafchromic EBT2 film is placed at the center of the cavity in coronal and sagittal orientations. The films are marked with a pin prick to identify the cavity center. Treatments are planned for delivery with 4 mm collimators using MRI and CT scans acquired with the clinical localizer boxes and acquisition protocols. Coordinates of shots are chosen so that the cavity is centered within the 50% isodose volume. Following irradiation, the films are scanned and analyzed. Targeting errors are defined as the distance between the pin prick and the centroid of the 50% isodose line. Results: Averaged over 10 patient simulations, targeting errors along the x, y and z coordinates (patient left-to-right, posterior-anterior, head-to-foot) were, respectively, −0.060 +/− 0.363, −0.350 +/− 0.253, and 0.364 +/− 0.191 mm when MRI was used for treatment planning. Planning according to CT exhibited generally smaller errors, namely 0.109 +/− 0.167, −0.191 +/− 0.144, and 0.211 +/− 0.94 mm. The largest errors in MRI and CT planned treatments were, respectively, y = −0.761 and x = 0.428 mm. Conclusion: Unless patient motion or stronger MRI image distortion in actual treatments caused additional errors, all patients received the prescribed dose, i.e., the targeted section of the trig±eminal nerve was contained within the 50% isodose surface in all cases.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

WE-G-17A-04: Measurements of the Electron-Return-Effect in a Commercial Magnetic Resonance Image Guided Radiation Therapy (MR-IGRT) System

Purpose: The aim of this work was to measure the influences of the Lorentz force (electron return effect) on secondary electron transport in the presence of a low magnetic field produced in a commercial MR-IGRT system using a custom heterogeneous phantom. Methods: A commercial MR-IGRT system has been commissioned in our department. The system combines real-time imaging using a split-bore 0.35-T MRI and three Co-60 heads, each collimated with a doubly-focused MLC. The integrated treatment planning system uses a Monte-Carlo algorithm that models the magnetic field effects on scattered electrons. During commissioning, a custom heterogeneity phantom was designed to acquire ionization chamber and film measurements. The 30 cm cubic phantom consists of two waterfilled annuli, each containing a central region that simulates a 6 cm cubic lung tumor using polystyrene embedded in cork. Film may be placed inbetween the halves, and small-volume ionization chambers may be placed in different positions to measure dose to the tumor and near interfaces where the electron return effect is expected. The treatment planning system was used to create open-field and IMRT treatment plans on a CT scan of the phantom. Plans were delivered to the phantom, and radiographic film and ionization chamber measurements were obtained. Results: The mean ionization chamber measured dose ratio for 27 measurements for 5 plans was 0.993 ± 0.027. Lateral profile film measurements confirm that the electron-return-effect is observable, producing local dose variations of less than 10% over 5 mm with 0.35 T magnetic field for single field treatment plans. The effect becomes negligible for opposing-field and IMRT treatments. Conclusion: A heterogeneous phantom for measurement of the electron-return-effect has been designed. Ionization chamber and film measurements made with the phantom indicate that the dosimetric effect is minimal, and the treatment planning system predicts dose reasonably well for complex heterogeneous scenarios.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

TH-C-BRD-02: Analytical Modeling and Dose Calculation Method for Asymmetric Proton Pencil Beams

Purpose: A dynamic collimation system (DCS), which consists of two pairs of orthogonal trimmer blades driven by linear motors has been proposed to decrease the lateral penumbra in pencil beam scanning proton therapy. The DCS reduces lateral penumbra by intercepting the proton pencil beam near the lateral boundary of the target in the beam's eye view. The resultant trimmed pencil beams are asymmetric and laterally shifted, and therefore existing pencil beam dose calculation algorithms are not capable of trimmed beam dose calculations. This work develops a method to model and compute dose from trimmed pencil beams when using the DCS. Methods: MCNPX simulations were used to determine the dose distributions expected from various trimmer configurations using the DCS. Using these data, the lateral distribution for individual beamlets was modeled with a 2D asymmetric Gaussian function. The integral depth dose (IDD) of each configuration was also modeled by combining the IDD of an untrimmed pencil beam with a linear correction factor. The convolution of these two terms, along with the Highland approximation to account for lateral growth of the beam along the depth direction, allows a trimmed pencil beam dose distribution to be analytically generated. The algorithm was validated by computing dose for a single energy layer 5×5 cm{sup 2} treatment field, defined by the trimmers, using both the proposed method and MCNPX beamlets. Results: The Gaussian modeled asymmetric lateral profiles along the principal axes match the MCNPX data very well (R{sup 2}≥0.95 at the depth of the Bragg peak). For the 5×5 cm{sup 2} treatment plan created with both the modeled and MCNPX pencil beams, the passing rate of the 3D gamma test was 98% using a standard threshold of 3%/3 mm. Conclusion: An analytical method capable of accurately computing asymmetric pencil beam dose when using the DCS has been developed.

07 ISOTOPE AND RADIATION SOURCES↗
DOE OSTI2014

MCTP system model based on linear programming optimization of apertures obtained from sequencing patient image data maps

Purpose: The authors present a hybrid direct multileaf collimator (MLC) aperture optimization model exclusively based on sequencing of patient imaging data to be implemented on a Monte Carlo treatment planning system (MC-TPS) to allow the explicit radiation transport simulation of advanced radiotherapy treatments with optimal results in efficient times for clinical practice. Methods: The planning system (called CARMEN) is a full MC-TPS, controlled through aMATLAB interface, which is based on the sequencing of a novel map, called “biophysical” map, which is generated from enhanced image data of patients to achieve a set of segments actually deliverable. In order to reduce the required computation time, the conventional fluence map has been replaced by the biophysical map which is sequenced to provide direct apertures that will later be weighted by means of an optimization algorithm based on linear programming. A ray-casting algorithm throughout the patient CT assembles information about the found structures, the mass thickness crossed, as well as PET values. Data are recorded to generate a biophysical map for each gantry angle. These maps are the input files for a home-made sequencer developed to take into account the interactions of photons and electrons with the MLC. For each linac (Axesse of Elekta and Primus of Siemens) and energy beam studied (6, 9, 12, 15 MeV and 6 MV), phase space files were simulated with the EGSnrc/BEAMnrc code. The dose calculation in patient was carried out with the BEAMDOSE code. This code is a modified version of EGSnrc/DOSXYZnrc able to calculate the beamlet dose in order to combine them with different weights during the optimization process. Results: Three complex radiotherapy treatments were selected to check the reliability of CARMEN in situations where the MC calculation can offer an added value: A head-and-neck case (Case I) with three targets delineated on PET/CT images and a demanding dose-escalation; a partial breast irradiation case (Case II) solved with photon and electron modulated beams (IMRT + MERT); and a prostatic bed case (Case III) with a pronounced concave-shaped PTV by using volumetric modulated arc therapy. In the three cases, the required target prescription doses and constraints on organs at risk were fulfilled in a short enough time to allow routine clinical implementation. The quality assurance protocol followed to check CARMEN system showed a high agreement with the experimental measurements. Conclusions: A Monte Carlo treatment planning model exclusively based on maps performed from patient imaging data has been presented. The sequencing of these maps allows obtaining deliverable apertures which are weighted for modulation under a linear programming formulation. The model is able to solve complex radiotherapy treatments with high accuracy in an efficient computation time.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Development of a novel depth of interaction PET detector using highly multiplexed G-APD cross-strip encoding

Purpose: The aim of this study was to develop a prototype PET detector module for a combined small animal positron emission tomography and magnetic resonance imaging (PET/MRI) system. The most important factor for small animal imaging applications is the detection sensitivity of the PET camera, which can be optimized by utilizing longer scintillation crystals. At the same time, small animal PET systems must yield a high spatial resolution. The measured object is very close to the PET detector because the bore diameter of a high field animal MR scanner is limited. When used in combination with long scintillation crystals, these small-bore PET systems generate parallax errors that ultimately lead to a decreased spatial resolution. Thus, we developed a depth of interaction (DoI) encoding PET detector module that has a uniform spatial resolution across the whole field of view (FOV), high detection sensitivity, compactness, and insensitivity to magnetic fields. Methods: The approach was based on Geiger mode avalanche photodiode (G-APD) detectors with cross-strip encoding. The number of readout channels was reduced by a factor of 36 for the chosen block elements. Two 12 × 2 G-APD strip arrays (25μm cells) were placed perpendicular on each face of a 12 × 12 lutetium oxyorthosilicate crystal block with a crystal size of 1.55 × 1.55 × 20 mm. The strip arrays were multiplexed into two channels and used to calculate the x, y coordinates for each array and the deposited energy. The DoI was measured in step sizes of 1.8 mm by a collimated {sup 18}F source. The coincident resolved time (CRT) was analyzed at all DoI positions by acquiring the waveform for each event and applying a digital leading edge discriminator. Results: All 144 crystals were well resolved in the crystal flood map. The average full width half maximum (FWHM) energy resolution of the detector was 12.8% ± 1.5% with a FWHM CRT of 1.14 ± 0.02 ns. The average FWHM DoI resolution over 12 crystals was 2.90 ± 0.15 mm. Conclusions: The novel DoI PET detector, which is based on strip G-APD arrays, yielded a DoI resolution of 2.9 mm and excellent timing and energy resolution. Its high multiplexing factor reduces the number of electronic channels. Thus, this cross-strip approach enables low-cost, high-performance PET detectors for dedicated small animal PET and PET/MRI and potentially clinical PET/MRI systems.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

Explicit solutions of the radiative transport equation in the P{sub 3} approximation

Purpose: Explicit solutions of the monoenergetic radiative transport equation in the P{sub 3} approximation have been derived which can be evaluated with nearly the same computational effort as needed for solving the standard diffusion equation (DE). In detail, the authors considered the important case of a semi-infinite medium which is illuminated by a collimated beam of light. Methods: A combination of the classic spherical harmonics method and the recently developed method of rotated reference frames is used for solving the P{sub 3} equations in closed form. Results: The derived solutions are illustrated and compared to exact solutions of the radiative transport equation obtained via the Monte Carlo (MC) method as well as with other approximated analytical solutions. It is shown that for the considered cases which are relevant for biomedical optics applications, the P{sub 3} approximation is close to the exact solution of the radiative transport equation. Conclusions: The authors derived exact analytical solutions of the P{sub 3} equations under consideration of boundary conditions for defining a semi-infinite medium. The good agreement to Monte Carlo simulations in the investigated domains, for example, in the steady-state and time domains, as well as the short evaluation time needed suggests that the derived equations can replace the often applied solutions of the diffusion equation for the homogeneous semi-infinite medium.

71 CLASSICAL AND QUANTUM MECHANICS, GENERAL PHYSIC↗
DOE OSTI2014

CT reconstruction techniques for improved accuracy of lung CT airway measurement

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

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2014

Using an external surrogate for predictor model training in real-time motion management of lung tumors

Purpose: Precise prediction of respiratory motion is a prerequisite for real-time motion compensation techniques such as beam, dynamic couch, or dynamic multileaf collimator tracking. Collection of tumor motion data to train the prediction model is required for most algorithms. To avoid exposure of patients to additional dose from imaging during this procedure, the feasibility of training a linear respiratory motion prediction model with an external surrogate signal is investigated and its performance benchmarked against training the model with tumor positions directly. Methods: The authors implement a lung tumor motion prediction algorithm based on linear ridge regression that is suitable to overcome system latencies up to about 300 ms. Its performance is investigated on a data set of 91 patient breathing trajectories recorded from fiducial marker tracking during radiotherapy delivery to the lung of ten patients. The expected 3D geometric error is quantified as a function of predictor lookahead time, signal sampling frequency and history vector length. Additionally, adaptive model retraining is evaluated, i.e., repeatedly updating the prediction model after initial training. Training length for this is gradually increased with incoming (internal) data availability. To assess practical feasibility model calculation times as well as various minimum data lengths for retraining are evaluated. Relative performance of model training with external surrogate motion data versus tumor motion data is evaluated. However, an internal–external motion correlation model is not utilized, i.e., prediction is solely driven by internal motion in both cases. Results: Similar prediction performance was achieved for training the model with external surrogate data versus internal (tumor motion) data. Adaptive model retraining can substantially boost performance in the case of external surrogate training while it has little impact for training with internal motion data. A minimum adaptive retraining data length of 8 s and history vector length of 3 s achieve maximal performance. Sampling frequency appears to have little impact on performance confirming previously published work. By using the linear predictor, a relative geometric 3D error reduction of about 50% was achieved (using adaptive retraining, a history vector length of 3 s and with results averaged over all investigated lookahead times and signal sampling frequencies). The absolute mean error could be reduced from (2.0 ± 1.6) mm when using no prediction at all to (0.9 ± 0.8) mm and (1.0 ± 0.9) mm when using the predictor trained with internal tumor motion training data and external surrogate motion training data, respectively (for a typical lookahead time of 250 ms and sampling frequency of 15 Hz). Conclusions: A linear prediction model can reduce latency induced tracking errors by an average of about 50% in real-time image guided radiotherapy systems with system latencies of up to 300 ms. Training a linear model for lung tumor motion prediction with an external surrogate signal alone is feasible and results in similar performance as training with (internal) tumor motion. Particularly for scenarios where motion data are extracted from fluoroscopic imaging with ionizing radiation, this may alleviate the need for additional imaging dose during the collection of model training data.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2014

Beamlet based direct aperture optimization for MERT using a photon MLC

Purpose: A beamlet based direct aperture optimization (DAO) for modulated electron radiotherapy (MERT) using photon multileaf collimator (pMLC) shaped electron fields is developed and investigated. Methods: The Swiss Monte Carlo Plan (SMCP) allows the calculation of dose distributions for pMLC shaped electron beams. SMCP is interfaced with the Eclipse TPS (Varian Medical Systems, Palo Alto, CA) which can thus be included into the inverse treatment planning process for MERT. This process starts with the import of a CT-scan into Eclipse, the contouring of the target and the organs at risk (OARs), and the choice of the initial electron beam directions. For each electron beam, the number of apertures, their energy, and initial shape are defined. Furthermore, the DAO requires dose–volume constraints for the structures contoured. In order to carry out the DAO efficiently, the initial electron beams are divided into a grid of beamlets. For each of those, the dose distribution is precalculated using a modified electron beam model, resulting in a dose list for each beamlet and energy. Then the DAO is carried out, leading to a set of optimal apertures and corresponding weights. These optimal apertures are now converted into pMLC shaped segments and the dose calculation for each segment is performed. For these dose distributions, a weight optimization process is launched in order to minimize the differences between the dose distribution using the optimal apertures and the pMLC segments. Finally, a deliverable dose distribution for the MERT plan is obtained and loaded back into Eclipse for evaluation. For an idealized water phantom geometry, a MERT treatment plan is created and compared to the plan obtained using a previously developed forward planning strategy. Further, MERT treatment plans for three clinical situations (breast, chest wall, and parotid metastasis of a squamous cell skin carcinoma) are created using the developed inverse planning strategy. The MERT plans are compared to clinical standard treatment plans using photon beams and the differences between the optimal and the deliverable dose distributions are determined. Results: For the idealized water phantom geometry, the inversely optimized MERT plan is able to obtain the same PTV coverage, but with an improved OAR sparing compared to the forwardly optimized plan. Regarding the right-sided breast case, the MERT plan is able to reduce the lung volume receiving more than 30% of the prescribed dose and the mean lung dose compared to the standard plan. However, the standard plan leads to a better homogeneity within the CTV. The results for the left-sided thorax wall are similar but also the dose to the heart is reduced comparing MERT to the standard treatment plan. For the parotid case, MERT leads to lower doses for almost all OARs but to a less homogeneous dose distribution for the PTV when compared to a standard plan. For all cases, the weight optimization successfully minimized the differences between the optimal and the deliverable dose distribution. Conclusions: A beamlet based DAO using multiple beam angles is implemented and successfully tested for an idealized water phantom geometry and clinical situations.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Robust primary modulation-based scatter estimation for cone-beam CT

Purpose: Scattered radiation is one of the major problems facing image quality in flat detector cone-beam computed tomography (CBCT). Previously, a new scatter estimation and correction method using primary beam modulation has been proposed. The original image processing technique used a frequency-domain-based analysis, which proved to be sensitive to the accuracy of the modulator pattern both spatially and in amplitude as well as to the frequency of the modulation pattern. In addition, it cannot account for penumbra effects that occur, for example, due to the finite focal spot size and the scatter estimate can be degraded by high-frequency components of the primary image. Methods: In this paper, the authors present a new way to estimate the scatter using primary modulation. It is less sensitive to modulator nonidealities and most importantly can handle arbitrary modulator shapes and changes in modulator attenuation. The main idea is that the scatter estimation can be expressed as an optimization problem, which yields a separation of the scatter and the primary image. The method is evaluated using simulated and experimental CBCT data. The scattering properties of the modulator itself are analyzed using a Monte Carlo simulation. Results: All reconstructions show strong improvements of image quality. To quantify the results, all images are compared to reference images (ideal simulations and collimated scans). Conclusions: The proposed modulator-based scatter reduction algorithm may open the field of flat detector-based imaging to become a quantitative modality. This may have significant impact on C-arm imaging and on image-guided radiation therapy.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2015

Fiber-optic detector for real time dosimetry of a micro-planar x-ray beam

Purpose: Here, the authors describe a dosimetry measurement technique for microbeam radiation therapy using a nanoparticle-terminated fiber-optic dosimeter (nano-FOD). Methods: The nano-FOD was placed in the center of a 2 cm diameter mouse phantom to measure the deep tissue dose and lateral beam profile of a planar x-ray microbeam. Results: The continuous dose rate at the x-ray microbeam peak measured with the nano-FOD was 1.91 ± 0.06 cGy s{sup −1}, a value 2.7% higher than that determined via radiochromic film measurements (1.86 ± 0.15 cGy s{sup −1}). The nano-FOD-determined lateral beam full-width half max value of 420 μm exceeded that measured using radiochromic film (320 μm). Due to the 8° angle of the collimated microbeam and resulting volumetric effects within the scintillator, the profile measurements reported here are estimated to achieve a resolution of ∼0.1 mm; however, for a beam angle of 0°, the theoretical resolution would approach the thickness of the scintillator (∼0.01 mm). Conclusions: This work provides proof-of-concept data and demonstrates that the novel nano-FOD device can be used to perform real-time dosimetry in microbeam radiation therapy to measure the continuous dose rate at the x-ray microbeam peak as well as the lateral beam shape.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2015

Creation of an atlas of filter positions for fluence field modulated CT

Purpose: Fluence field modulated CT (FFMCT) and volume of interest (VOI) CT imaging applications require adjustment of the profile of the x-ray fluence incident on a patient as a function of view angle. Since current FFMCT prototypes can theoretically take on an infinite number of configurations, measuring a calibration data set for all possible positions would not be feasible. The present work details a methodology for calculating an atlas of configurations that will span all likely body regions, patient sizes, patient positioning, and imaging modes. The hypothesis is that there exists a finite number of unique modulator configurations that effectively span the infinite number of possible fluence profiles with minimal loss in performance. Methods: CT images of a head, shoulder, thorax, abdominal, wrist, and leg anatomical slices were dilated and contracted to model small, medium, and large sized patients. Additionally, the images were positioned from iso-center by three different amounts. The modulator configurations required to compensate for each image were computed assuming a FFMCT prototype, digital beam attenuator, (DBA), was set to equalize the detector exposure. Each atlas configuration should be different from the other atlas configurations. The degree of difference was quantified using the sum of the absolute differences in filter thickness between configurations. Using this metric, a set of unique wedge configurations for which no two configurations have a metric value smaller than some threshold can be constructed. Differences in the total number of incident photons between the unconstrained filters and the atlas were studied as a function of the number of atlas positions for each anatomical site and size/off-centering combination. Results: By varying the threshold used in creating the atlas, it was found that roughly 322 atlas positions provided an incident number of photons within 20% of using 19 440 unique filters (the number of atlas entries ranged from 7213 to 1). Additionally, for VOI applications implemented with a single VOI region, the number of required filter configurations was expressed in a simple closed form solution. Conclusions: The methodology proposed in this work will enable DBA-FFMCT and DBA-VOI imaging in the clinic without the need for patient specific air-scans to be performed. In addition, the methodology proposed here is directly applicable to other modulator designs such as piecewise linear, TomoTherapy multi leaf collimators, 2D fluid arrays, and inverse geometry CT.

60 APPLIED LIFE SCIENCES↗