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TH-A-18C-06: A Scatter Elimination Scheme for Cone Beam CT Using An Oscillating Narrow Beam

Purpose: While cone beam CT (CBCT) has been widely used in image guided radiation therapy, its low image quality, primarily caused by scattered x-rays, hinders advanced clinical applications, e.g., CBCT based on-line adaptive re-planning. We propose in this abstract a new scheme called oscillating narrow beam CBCT (ONB-CBCT) to eliminate scatter signals. Methods: ONB-CBCT consists of two major components. 1) Oscillating narrow beam (ONB) scan and 2) partitioned flat panel containing multiple individual detector strips and their own readouts. Both the beam oscillation and detector partition are along the superior-inferior (SI) direction. During data acquisition, at a given projection, the narrow beam sweep through the detector region, and different portions of the detector acquires projection data in synchrony with the narrow beam. ONB can be generated by a rotating slit collimator design with conventional tube with single focal spot, or by directly using a new source with multiple focal spots. A proof-of-principle study via Monte Carlo simulation is conducted to demonstrate the feasibility of ONB-CBCT. Results: As the beam becomes narrower, more and more scatter signals are eliminated. For the case with a bowtie filter and using 15 ONBs, the maximum and the average intensity error due to scatter are below 20 and 10 HU, respectively. Conclusion: ONB yields a narrowed exposure field at each snapshot and hence an inherently negligible scatter effect. Meanwhile, the individualized detector units guarantee high frame rate detection and hence a same large volume coverage as that in conventional CBCT. In summary, ONB-CBCT is a promising design to achieve high-quality CBCT imaging. This study is supported in part by NIH (1R01CA154747-01)

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

TH-C-19A-05: Evaluation of a New Reusable 3D Dosimeter

Purpose: PRESAGE is a radiochromic plastic which has demonstrated strong potential for high resolution single-use 3D dosimetry. This study evaluates a new PRESAGE formulation (Presage-RU) in which the radiochromic response is reversible (the dosimeter optically clears after irradiation), enabling the potential for reusability. Methods: Presage-RU dose response and optical-clearing rates were evaluated in both small volume dosimeters (1×1×4.5cm) and a larger cylindrical dosimeter (8cm diameter, 4.5cm length). All dosimeters were allowed to fully optically clear in dark, room temperature conditions between irradiations. Dose response was determined by irradiating small volume samples from 0–8.0Gy and measuring change in optical density. The cylindrical dosimeter was irradiated with a simple 4-field box plan (parallel opposed pairs of 4cm×4cm AP-PA beams and 2cm×4cm lateral beams) to 20Gy. High resolution 3D dosimetry was achieved utilizing optical-CT readout. Readings were tracked up to 14 days to characterize optical clearing. Results: Initial irradiation yielded a response of 0.0119△OD/(Gy*cm) while two subsequent reirradiations yielded a lower but consistent response of 0.0087△OD/(Gy*cm). Strong linearity of dose response was observed for all irradiations. In the large cylindrical dosimeter, the integral dose within the high dose region exhibited an exponential decay in signal over time (halflife= 23.9 hours), with the dosimeter effectively cleared (0.04% of the initial signal) after 10 days. Subsequent irradiation resulted in 19.5% lower initial signal but demonstrated that the exponential clearing rate remained consistent. Results of additional subsequent irradiations will also be presented. Conclusion: This work introduces a new re-usable radiochromic dosimeter (Presage-RU) compatible with high resolution (sub-millimeter) 3D dosimetry. Sensitivity of the initial radiation was observed to be slightly higher than subsequent irradiations, but the clearing time remained constant, indicating the dosimeter can be re-used after 10 days. Presage-RU has potential to dramatically improve cost-effectiveness and thereby lower the barrier for implementing comprehensive, high resolution 3D dosimetry. John Adamovics is the president of Heuris Inc., which commercializes PRESAGE.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

TH-C-19A-12: Two-Dimensional High Spatial-Resolution Dosimeter Using Europium Doped Potassium Chloride

Purpose: Recent research has shown that KCl:Eu2+ has great potential for use in megavoltage radiation therapy dosimetry because this material exhibits excellent storage performance and is reusable due to strong radiation hardness. This work reports our attempts to fabricate 2D KCl:Eu2+ storage phosphor films (SPFs) using both a physical vapor deposition (PVD) method and a tape casting method. Methods: A thin layer of KCl:Eu2+ was deposited on a substrate of borosilicate glass (e.g., laboratory slides) with a PVD system. For tape casting, a homogenous suspension containing storage phosphor particles, liquid vehicle and polymer binder was formed and subsequently cast by doctor-blade onto a polyethylene terephthalate substrate to form a 150 μm thick SPF. Results: X ray diffraction analysis showed that a 10 μm thick PVD sample was composed of highly crystalline KCl. No additional phases were observed, suggesting that the europium activator had completed been incorporated into the KCl matrix. Photostimulated luminescence and photoluminescence spectra suggested that F (Cl−) centers were the electron storage centers post x ray irradiation and that Eu2+ cations acted as luminescence centers in the photostimulation process. The 150 μm thick casted KCl:Eu2+ SPF showed sub-millimeter spatial resolution. Monte Carlo simulations further demonstrated that the admixture of 20% KCl:Eu2+ and 80% low Z polymer binder exhibited almost no energy dependence in a 6 MV beam. KCl:Eu2+ pellet samples showed a large dynamic range from 0.01 cGy to 60 Gy dose-to-water, and saturated at approximately 500 Gy as a Result of its intrinsic high radiation hardness. Conclusions: This discovery research provides strong evidence that KCl:Eu2+ based SPF with associated readout apparatus could Result in a novel electronic film system that has all the desirable features associated with classic radiographic film and, importantly, water equivalence and the capability of permanent identification of each detector. This work was supported in part by NIH Grant No. R01CA148853. The authors would like to thank Paul Leblans (AGFA Healthcare, Belgium) for many helpful discussions on this topic.

61 RADIATION PROTECTION AND DOSIMETRY↗

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 ↗

Amorphous In–Ga–Zn–O thin-film transistor active pixel sensor x-ray imager for digital breast tomosynthesis

Purpose: The breast cancer detection rate for digital breast tomosynthesis (DBT) is limited by the x-ray image quality. The limiting Nyquist frequency for current DBT systems is around 5 lp/mm, while the fine image details contained in the high spatial frequency region (>5 lp/mm) are lost. Also today the tomosynthesis patient dose is high (0.67–3.52 mGy). To address current issues, in this paper, for the first time, a high-resolution low-dose organic photodetector/amorphous In–Ga–Zn–O thin-film transistor (a-IGZO TFT) active pixel sensor (APS) x-ray imager is proposed for next generation DBT systems. Methods: The indirect x-ray detector is based on a combination of a novel low-cost organic photodiode (OPD) and a cesium iodide-based (CsI:Tl) scintillator. The proposed APS x-ray imager overcomes the difficulty of weak signal detection, when small pixel size and low exposure conditions are used, by an on-pixel signal amplification with a significant charge gain. The electrical performance of a-IGZO TFT APS pixel circuit is investigated by SPICE simulation using modified Rensselaer Polytechnic Institute amorphous silicon (a-Si:H) TFT model. Finally, the noise, detective quantum efficiency (DQE), and resolvability of the complete system are modeled using the cascaded system formalism. Results: The result demonstrates that a large charge gain of 31–122 is achieved for the proposed high-mobility (5–20 cm{sup 2}/V s) amorphous metal-oxide TFT APS. The charge gain is sufficient to eliminate the TFT thermal noise, flicker noise as well as the external readout circuit noise. Moreover, the low TFT (<10{sup −13} A) and OPD (<10{sup −8} A/cm{sup 2}) leakage currents can further reduce the APS noise. Cascaded system analysis shows that the proposed APS imager with a 75 μm pixel pitch can effectively resolve the Nyquist frequency of 6.67 lp/mm, which can be further improved to ∼10 lp/mm if the pixel pitch is reduced to 50 μm. Moreover, the detector entrance exposure per projection can be reduced from 1 to 0.3 mR without a significant reduction of DQE. The signal-to-noise ratio of the a-IGZO APS imager under 0.3 mR x-ray exposure is comparable to that of a-Si:H passive pixel sensor imager under 1 mR, indicating good image quality under low dose. A threefold reduction of current tomosynthesis dose is expected if proposed technology is combined with an advanced DBT image reconstruction method. Conclusions: The proposed a-IGZO APS x-ray imager with a pixel pitch <75 μm is capable to achieve a high spatial frequency (>6.67 lp/mm) and a low dose (<0.4 mGy) in next generation DBT systems.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Sci—Thur PM: Imaging — 03: A novel Čerenkov detector based on air-spaced light guiding taper for megavoltage x-ray imaging

Electronic Portal Imaging Devices (EPIDs) have been used in radiation therapy and are still needed on linear accelerators (Linacs) equipped with kilovoltage cone beam CT (kV-CBCT) or MRI systems. Recently a new concept of a high quantum efficiency (QE) Čerenkov Portal Imaging Device (CPID) for MV x-ray imaging in radiation therapy was introduced. It relies on Čerenkov effect for x-ray detection. The proposed design consisted of a matrix of optical fibres aligned with the incident x-rays and coupled to an active matrix flat panel imager (AMFPI) for image readout. A weakness of such design is that too few Čerenkov light photons reach the AMFPI for each incident x-ray and an AMFPI with an avalanche gain is required. In this work we propose to replace the optical fibers in the CPID with light guides without a cladding layer that are suspended in air. The air between the light guides takes on the role of the cladding layer found in a regular optical fiber. Since air has a significantly lower refractive index, a much superior light collection efficiency is achieved. Our Monte Carlo studies have shown that the modified new CPID has a QE more than an order of magnitude greater than that of current clinical systems and yet a spatial resolution similar to that of current flat-panel based EPIDs. Furthermore it has been demonstrated that the new CPID does not require an avalanche gain in the AMFPI and is quantum noise limited at dose levels corresponding to a single Linac pulse.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Investigating the accuracy of microstereotactic-body-radiotherapy utilizing anatomically accurate 3D printed rodent-morphic dosimeters

Purpose: Sophisticated small animal irradiators, incorporating cone-beam-CT image-guidance, have recently been developed which enable exploration of the efficacy of advanced radiation treatments in the preclinical setting. Microstereotactic-body-radiation-therapy (microSBRT) is one technique of interest, utilizing field sizes in the range of 1–15 mm. Verification of the accuracy of microSBRT treatment delivery is challenging due to the lack of available methods to comprehensively measure dose distributions in representative phantoms with sufficiently high spatial resolution and in 3 dimensions (3D). This work introduces a potential solution in the form of anatomically accurate rodent-morphic 3D dosimeters compatible with ultrahigh resolution (0.3 mm{sup 3}) optical computed tomography (optical-CT) dose read-out. Methods: Rodent-morphic dosimeters were produced by 3D-printing molds of rodent anatomy directly from contours defined on x-ray CT data sets of rats and mice, and using these molds to create tissue-equivalent radiochromic 3D dosimeters from Presage. Anatomically accurate spines were incorporated into some dosimeters, by first 3D printing the spine mold, then forming a high-Z bone equivalent spine insert. This spine insert was then set inside the tissue equivalent body mold. The high-Z spinal insert enabled representative cone-beam CT IGRT targeting. On irradiation, a linear radiochromic change in optical-density occurs in the dosimeter, which is proportional to absorbed dose, and was read out using optical-CT in high-resolution (0.5 mm isotropic voxels). Optical-CT data were converted to absolute dose in two ways: (i) using a calibration curve derived from other Presage dosimeters from the same batch, and (ii) by independent measurement of calibrated dose at a point using a novel detector comprised of a yttrium oxide based nanocrystalline scintillator, with a submillimeter active length. A microSBRT spinal treatment was delivered consisting of a 180° continuous arc at 225 kVp with a 20 × 10 mm field size. Dose response was evaluated using both the Presage/optical-CT 3D dosimetry system described above, and independent verification in select planes using EBT2 radiochromic film placed inside rodent-morphic dosimeters that had been sectioned in half. Results: Rodent-morphic 3D dosimeters were successfully produced from Presage radiochromic material by utilizing 3D printed molds of rat CT contours. The dosimeters were found to be compatible with optical-CT dose readout in high-resolution 3D (0.5 mm isotropic voxels) with minimal artifacts or noise. Cone-beam CT image guidance was possible with these dosimeters due to sufficient contrast between high-Z spinal inserts and tissue equivalent Presage material (CNR ∼10 on CBCT images). Dose at isocenter measured with optical-CT was found to agree with nanoscintillator measurement to within 2.8%. Maximum dose in line profiles taken through Presage and film dose slices agreed within 3%, with FWHM measurements through each profile found to agree within 2%. Conclusions: This work demonstrates the feasibility of using 3D printing technology to make anatomically accurate Presage rodent-morphic dosimeters incorporating spinal-mimicking inserts. High quality optical-CT 3D dosimetry is feasible on these dosimeters, despite the irregular surfaces and implanted inserts. The ability to measure dose distributions in anatomically accurate phantoms represents a powerful useful additional verification tool for preclinical microSBRT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Incorporating multislice imaging into x-ray CT polymer gel dosimetry

Purpose: To evaluate multislice computed tomography (CT) scanning for fast and reliable readout of radiation therapy (RT) dose distributions using CT polymer gel dosimetry (PGD) and to establish a baseline assessment of image noise and uniformity in an unirradiated gel dosimeter. Methods: A 16-slice CT scanner was used to acquire images through a 1 L cylinder filled with water. Additional images were collected using a single slice machine. The variability in CT number (N{sub CT}) associated with the anode heel effect was evaluated and used to define a new slice-by-slice background subtraction artifact removal technique for CT PGD. Image quality was assessed for the multislice system by evaluating image noise and uniformity. The agreement in N{sub CT} for slices acquired simultaneously using the multislice detector array was also examined. Further study was performed to assess the effects of increasing x-ray tube load on the constancy of measured N{sub CT} and overall scan time. In all cases, results were compared to the single slice machine. Finally, images were collected throughout the volume of an unirradiated gel dosimeter to quantify image noise and uniformity before radiation is delivered. Results: Slice-by-slice background subtraction effectively removes the variability in N{sub CT} observed across images acquired simultaneously using the multislice scanner and is the recommended background subtraction method when using a multislice CT system. Image noise was higher for the multislice system compared to the single slice scanner, but overall image quality was comparable between the two systems. Further study showed N{sub CT} was consistent across image slices acquired simultaneously using the multislice detector array for each detector configuration of the slice thicknesses examined. In addition, the multislice system was found to eliminate variations in N{sub CT} due to increasing x-ray tube load and reduce scanning time by a factor of 4 when compared to imaging a large volume using a single slice scanner. Images acquired through an unirradiated, active gel revealed N{sub CT} varies between the top and bottom of the 1 L cylinder as well as across the diameter of the cylinder by up to 7 HU. Conclusions: Multislice CT imaging has been evaluated for CT PGD and found to be the superior technique compared to single slice imaging in terms of the time required to complete a scan and the tube load characteristics associated with each scanning method. The implementation of multislice scanning is straightforward and expected to facilitate routine gel dosimetry measurements for complex dose distributions in modern RT centers.

60 APPLIED LIFE SCIENCES↗

Systematic calibration of an integrated x-ray and optical tomography system for preclinical radiation research

Purpose: The cone beam computed tomography (CBCT) guided small animal radiation research platform (SARRP) has been developed for focal tumor irradiation, allowing laboratory researchers to test basic biological hypotheses that can modify radiotherapy outcomes in ways that were not feasible previously. CBCT provides excellent bone to soft tissue contrast, but is incapable of differentiating tumors from surrounding soft tissue. Bioluminescence tomography (BLT), in contrast, allows direct visualization of even subpalpable tumors and quantitative evaluation of tumor response. Integration of BLT with CBCT offers complementary image information, with CBCT delineating anatomic structures and BLT differentiating luminescent tumors. This study is to develop a systematic method to calibrate an integrated CBCT and BLT imaging system which can be adopted onboard the SARRP to guide focal tumor irradiation. Methods: The integrated imaging system consists of CBCT, diffuse optical tomography (DOT), and BLT. The anatomy acquired from CBCT and optical properties acquired from DOT serve as a priori information for the subsequent BLT reconstruction. Phantoms were designed and procedures were developed to calibrate the CBCT, DOT/BLT, and the entire integrated system. Geometrical calibration was performed to calibrate the CBCT system. Flat field correction was performed to correct the nonuniform response of the optical imaging system. Absolute emittance calibration was performed to convert the camera readout to the emittance at the phantom or animal surface, which enabled the direct reconstruction of the bioluminescence source strength. Phantom and mouse imaging were performed to validate the calibration. Results: All calibration procedures were successfully performed. Both CBCT of a thin wire and a euthanized mouse revealed no spatial artifact, validating the accuracy of the CBCT calibration. The absolute emittance calibration was validated with a 650 nm laser source, resulting in a 3.0% difference between simulated and measured signal. The calibration of the entire system was confirmed through the CBCT and BLT reconstruction of a bioluminescence source placed inside a tissue-simulating optical phantom. Using a spatial region constraint, the source position was reconstructed with less than 1 mm error and the source strength reconstructed with less than 24% error. Conclusions: A practical and systematic method has been developed to calibrate an integrated x-ray and optical tomography imaging system, including the respective CBCT and optical tomography system calibration and the geometrical calibration of the entire system. The method can be modified and adopted to calibrate CBCT and optical tomography systems that are operated independently or hybrid x-ray and optical tomography imaging systems.

60 APPLIED LIFE SCIENCES↗

SU-E-J-100: The Combination of Deformable Image Registration and Regions-Of-Interest Mapping Technique to Accomplish Accurate Dose Calculation On Cone Beam Computed Tomography for Esophageal Cancer

Purpose: We introduce a new method combined with the deformable image registration (DIR) and regions-of-interest mapping (ROIM) technique to accurately calculate dose on daily CBCT for esophageal cancer. Methods: Patients suffered from esophageal cancer were enrolled in the study. Prescription was set to 66 Gy/30 F and 54 Gy/30 F to the primary tumor (PTV66) and subclinical disease (PTV54) . Planning CT (pCT) were segmented into 8 substructures in terms of their differences in physical density, such as gross target volume (GTV), venae cava superior (SVC), aorta, heart, spinal cord, lung, muscle and bones. The pCT and its substructures were transferred to the MIM software to readout their mean HU values. Afterwards, a deformable planning CT to daily KV-CBCT image registration method was then utilized to acquire a new structure set on CBCT. The newly generated structures on CBCT were then transferred back to the treatment planning system (TPS) and its HU information were overridden manually with mean HU values obtained from pCT. Finally, the treatment plan was projected onto the CBCT images with the same beam arrangements and monitor units (MUs) to accomplish dose calculation. Planning target volume (PTV) and organs at risk (OARs) from both of the pCT and CBCT were compared to evaluate the dose calculation accuracy. Results: It was found that the dose distribution in the CBCT showed little differences compared to the pCT, regardless of whether PTV or OARs were concerned. Specifically, dose variation in GTV, PTV54, PTV66, SVC, lung and heart were within 0.1%. The maximum dose variation was presented in the spinal cord, which was up to 2.7% dose difference. Conclusion: The proposed method combined with DIR and ROIM technique to accurately calculate dose distribution on CBCT for esophageal cancer is feasible.

60 APPLIED LIFE SCIENCES↗

SU-E-T-92: Achieving Desirable Lung Doses in Total Body Irradiation Based On in Vivo Dosimetry and Custom Tissue Compensation

Purpose: To achieve desirable lung doses in total body irradiation (TBI) based on in vivo dosimetry and custom tissue compensation. Methods: The 15 MV photon beam of a Varian TrueBeam STx linac was used for TBI. Patients were positioned in the lateral decubitus position for AP/PA treatment delivery. Dose was calculated using the midpoint of the separation distance across the patient’s umbilicus. Patients received 200 cGy twice daily for 3 days. The dose rate at the patient’s midplane was approximately 10 cGy/min. Cerrobend blocks with a 5-HVL thickness were used for the primary lung shielding. A custom styrofoam holder for rice-flour filled bags was created based on the lung block cutouts. This was used to provide further lung shielding based on in vivo dose measurements. Lucite plates and rice-flour bags were placed in the head, neck, chest, and lower extremity regions during the treatment to compensate for the beam off-axis output variations. Two patients were included in the study. Patients 1 and 2 received a craniospinal treatment (1080 cGy) and a mediastinum treatment (2520 cGy), respectively, before the TBI. During the TBI nanoDot dosimeters were placed on the patient skin in the forehead, neck, umbilicus, and lung regions for dose monitoring. The doses were readout immediately after the treatment. Based on the readings, fine tuning of the thickness of the rice-flour filled bags was exploited to achieve the desirable lung doses. Results: For both patients the mean lung doses, which took into consideration all treatments, were controlled within 900 +/−10% cGy, as desired. Doses to the forehead, neck, and umbilicus were achieved within +/−10% of the prescribed dose (1200 cGy). Conclusion: A reliable and robust method was developed to achieve desirable lung doses and uniform body dose in TBI based on in vivo dosimetry and custom tissue compensator.

60 APPLIED LIFE SCIENCES↗

SU-E-T-296: Dosimetric Analysis of Small Animal Image-Guided Irradiator Using High Resolution Optical CT Imaging of 3D Dosimeters

Purpose: To verify the dosimetric characteristics of a small animal image-guided irradiator using a high-resolution of optical CT imaging of 3D dosimeters. Methods: PRESAEGE 3D dosimeters were used to determine dosimetric characteristics of a small animal image-guided irradiator and compared with EBT2 films. Cylindrical PRESAGE dosimeters with 7cm height and 6cm diameter were placed along the central axis of the beam. The films were positioned between 6×6cm{sup 2} cubed plastic water phantoms perpendicular to the beam direction with multiple depths. PRESAGE dosimeters and EBT2 films were then irradiated with the irradiator beams at 220kVp and 13mA. Each of irradiated PRESAGE dosimeters named PA1, PA2, PB1, and PB2, was independently scanned using a high-resolution single laser beam optical CT scanner. The transverse images were reconstructed with a 0.1mm high-resolution pixel. A commercial Epson Expression 10000XL flatbed scanner was used for readout of irradiated EBT2 films at a 0.4mm pixel resolution. PDD curves and beam profiles were measured for the irradiated PRESAGE dosimeters and EBT2 films. Results: The PDD agreements between the irradiated PRESAGE dosimeter PA1, PA2, PB1, PB2 and the EB2 films were 1.7, 2.3, 1.9, and 1.9% for the multiple depths at 1, 5, 10, 15, 20, 30, 40 and 50mm, respectively. The FWHM measurements for each PRESAEGE dosimeter and film agreed with 0.5, 1.1, 0.4, and 1.7%, respectively, at 30mm depth. Both PDD and FWHM measurements for the PRESAGE dosimeters and the films agreed overall within 2%. The 20%–80% penumbral widths of each PRESAGE dosimeter and the film at a given depth were respectively found to be 0.97, 0.91, 0.79, 0.88, and 0.37mm. Conclusion: Dosimetric characteristics of a small animal image-guided irradiator have been demonstrated with the measurements of PRESAGE dosimeter and EB2 film. With the high resolution and accuracy obtained from this 3D dosimetry system, precise targeting small animal irradiation can be achieved.

60 APPLIED LIFE SCIENCES↗

SU-E-T-475: Improvements to Total Body Irradiation Dosimetry Efficiency with EBT3 Radiochromic Film and a Template System

Purpose: Total Body Irradiation (TBI) treatments are mainly used in a preparative regimen for haematopoietic stem cell (or bone marrow) transplantation. Our standard regimen is a 12 Gy / 6 fraction bi-daily technique. To evaluate the delivered dose homogeneity to the patient, EBT3 Gafchromic film is positioned at the head, neck, chest, pelvis and groin for all fractions. A system has been developed to simply and accurately prepare and readout the films for patient dose assessment. Methods: A process involving easy preparation and analysis has been produced to minimise the time requirements for TBI dosimetry. One sheet of EBT3 film is used to prepare treatment dosimeters for all fractions, including calibration films, and an automated dose analysis system for easy evaluation and calculation of estimated in-vivo doses was developed. A desktop scanner is used with a dedicated TBI film template to accurately position the films for Image J analysis and extraction. Dental wax bolus and zip-lock bag holders are used to hold the EBT3 film in place during irradiation. Results: To adequately provide dosimetry information for a 6 fraction, TBI patient, only one sheet of Gafchromic EBT3 film is required. The dosimeters are cut, using a template, into 19 mm squares which are then placed between two 30 mm x 30 mm x 4.5 mm wax blocks for bolus. All packages are prepared before the first treatment fraction. The scanning and analysis process can be completed in less than 10 minutes after a 240 min development period. Results have shown that a high level of accuracy and reproducibility can be achieved using the template system provided. Conclusion: Gafchromic EBT3 film provides an adequate in-vivo dosimetry measure for TBI patients. Using a template based system on a dedicated desktop scanner, in-vivo results can be ascertained quickly and accurately.

60 APPLIED LIFE SCIENCES↗

MO-F-CAMPUS-J-01: A Novel and Efficient Daily QA Program for Both Modern Linear Accelerator and Optical Surface Motion Systems

Purpose: The camera-based optical surface monitoring system(OSMS) is a standard motion-tracking system for TrueBeam™ machine. Daily quality assurance(DQA) procedures for the TrueBeam and OSMS systems currently require multiple phantoms and test sequences. Machine Performance Check(MPC) uses the IsoCal™ phantom to test geometric and dosimetric aspects, and has been validated for routine TrueBeam DQA. This work examines the novel use of MPC to simultaneously conduct DQA of OSMS,utilizing one phantom and test sequence for QA of both the TrueBeam and OSMS systems. Methods: TrueBeam with 6 degree-of-freedom(6DOF) couch, MPC and OSMS were installed. The therapists routinely use MPC with the IsoCal phantom to verify geometric and dosimetric parameters with an automated sequence of varying gantry and collimator angles, MLC positions, and couch translations and rotations as the DQA for TrueBeam. A surface outline of the IsoCal phantom, generated from a CT dataset, was imported to OSMS and used to monitor the position of the phantom at isocenter and to track its movement up to 5cm/10°(yaw) and rotation in pitch and roll up to 3° in real time during the automated MPC sequence. Motion of the phantom throughout the MPC routine was compared to the couch position shown by the digital readout. Results: The coincidence of isocenter, as determined by OSMS, and TrueBeam radiation isocenter was within ±0.8mm/±0.8° in three axes. Between OSMS and TrueBeam 6DOF couch, the mean couch relative shifts/angles were within ±0.7mm/±0.8° for each axis. Reported pitch and roll values were within ±0.4mm/±0.4°. The total measurement time for each DQA session took approximately 5 minutes. Conclusion: Use of the IsoCal phantom and MPC for simultaneous DQA of TrueBeam and OSMS increases QA efficiency and reduces complexity. OSMS isocenter position and motion-tracking capability in 6DOF were verified in real-time and were found to be within 1mm of the expected value.

60 APPLIED LIFE SCIENCES↗

WE-AB-BRB-04: A Novel Monolithic Silicon 2D Detector Array for Use in Stereotactic Applications

Purpose: To assess the capability of a novel 2D monolithic silicon detector array in measuring stereotactic photon fields. Methods: The silicon array detector used in this work, named Magic Plate-512 (MP512), is a thin monolithic silicon wafer (52 × 52 × 0.47 mm{sup 3}) with 512 ion-implanted diodes (0.5 × 0.5 mm{sup 2}). Adjacent pixels are spaced evenly with 2 mm pitch, covering a maximum detection area 46 mm wide. Its fast, FPGA based read-out system is synchronised with the linac to allow readout of all pixels pulse-by-pulse. A clinical SABR lung plan (consisting of 9 single segment beams, 6MV) was measured with the array at 1.5 cm depth in a solid water phantom (100 cm SSD). The typical field size was in the range of 3 × 3 cm{sup 2} to 4 × 4 cm{sup 2}. Each beam was delivered at perpendicular incidence to the detector plane so as to avoid the need for angular dependence corrections. The fields were measured under the same conditions using Gafchromic EBT3 film for comparison. The film was scanned at 72 dpi resolution, with the red channel data used for analysis. Results: Average gamma passing rates of (92.3 ± 1.8) % for 2%/2mm criteria, and (86.6 ± 2.3) % for 1%/2mm criteria were achieved for MP512, using EBT3 film as the reference distribution. The detector array was able to accurately measure the full-width-at-half-maximum (FWHM), to within (0.77 ± 0.01) mm accuracy when compared to film. The penumbral widths (80%-20%) were measured to within (0.30 ± 0.01) mm accuracy to film. Conclusion: The MP512 is a feasible option for measurement of stereotactic photon fields, with its high density of detection points making it useful for small field applications. The prototype array has demonstrated merit; in the future the development of a larger array detection area would be beneficial for clinical applications.

60 APPLIED LIFE SCIENCES↗

WE-AB-204-04: Feature Selection and Clustering Optimization for Pseudo-CT Generation in MR-Based Attenuation Correction and Radiation Therapy Planning

Purpose: Accurate and robust photon attenuation derived from MR is essential for PET/MR and MR-based radiation treatment planning applications. Although the fuzzy C-means (FCM) algorithm has been applied for pseudo-CT generation, the input feature combination and the number of clusters have not been optimized. This study aims to optimize both for clinically practical pseudo-CT generation. Methods: Nine volunteers were recruited. A 190-second, single-acquisition UTE-mDixon with 25% (angular) sampling and 3D radial readout was performed to acquire three primitive MR features at TEs of 0.1, 1.5, and 2.8 ms: the free-induction-decay (FID), the first and the second echo images. Three derived images, Dixon-fat and Dixon-water generated by two-point Dixon water/fat separation, and R2* (1/T2*) map, were also created. To identify informative inputs for generating a pseudo-CT image volume, all 63 combinations, choosing one to six of the feature images, were used as inputs to FCM for pseudo-CT generation. Further, the number of clusters was varied from four to seven to find the optimal approach. Mean prediction deviation (MPD), mean absolute prediction deviation (MAPD), and correlation coefficient (R) of different combinations were compared for feature selection. Results: Among the 63 feature combinations, the four that resulted in the best MAPD and R were further compared along with the set containing all six features. The results suggested that R2* and Dixon-water are the most informative features. Further, including FID also improved the performance of pseudo-CT generation. Consequently, the set containing FID, Dixon-water, and R2* resulted in the most accurate, robust pseudo-CT when the number of cluster equals to five (5C). The clusters were interpreted as air, fat, bone, brain, and fluid. The six-cluster Result additionally included bone marrow. Conclusion: The results suggested that FID, Dixon-water, R2* are the most important features. The findings can be used to facilitate pseudo-CT generation for unsupervised clustering. Please note that the project was completed with partial funding from the Ohio Department of Development grant TECH 11-063 and a sponsored research agreement with Philips Healthcare that is managed by Case Western Reserve University. As noted in the affiliations, some of the authors are Philips employees.

60 APPLIED LIFE SCIENCES↗

WE-EF-207-03: Design and Optimization of a CBCT Head Scanner for Detection of Acute Intracranial Hemorrhage

Purpose: To design a dedicated x-ray cone-beam CT (CBCT) system suitable to deployment at the point-of-care and offering reliable detection of acute intracranial hemorrhage (ICH), traumatic brain injury (TBI), stroke, and other head and neck injuries. Methods: A comprehensive task-based image quality model was developed to guide system design and optimization of a prototype head scanner suitable to imaging of acute TBI and ICH. Previously reported models were expanded to include the effects of x-ray scatter correction necessary for detection of low contrast ICH and the contribution of bit depth (digitization noise) to imaging performance. Task-based detectablity index provided the objective function for optimization of system geometry, x-ray source, detector type, anti-scatter grid, and technique at 10–25 mGy dose. Optimal characteristics were experimentally validated using a custom head phantom with 50 HU contrast ICH inserts imaged on a CBCT imaging bench allowing variation of system geometry, focal spot size, detector, grid selection, and x-ray technique. Results: The model guided selection of system geometry with a nominal source-detector distance 1100 mm and optimal magnification of 1.50. Focal spot size ∼0.6 mm was sufficient for spatial resolution requirements in ICH detection. Imaging at 90 kVp yielded the best tradeoff between noise and contrast. The model provided quantitation of tradeoffs between flat-panel and CMOS detectors with respect to electronic noise, field of view, and readout speed required for imaging of ICH. An anti-scatter grid was shown to provide modest benefit in conjunction with post-acquisition scatter correction. Images of the head phantom demonstrate visualization of millimeter-scale simulated ICH. Conclusions: Performance consistent with acute TBI and ICH detection is feasible with model-based system design and robust artifact correction in a dedicated head CBCT system. Further improvements can be achieved with incorporation of model-based iterative reconstruction techniques also within the scope of the task-based optimization framework. David Foos and Xiaohui Wang are employees of Carestream Health.

60 APPLIED LIFE SCIENCES↗